Rohan Kulkarni — Healthcare Practice Leader, HFS Research[00:21]
Welcome to HFS Unfiltered. My name is Rohan Kulkarni, and I lead the healthcare practice at HFS Research. My guest today is Simone Rodriguez, a leader in Cognizant’s Health Sciences Strategy Organization. Welcome, Simone.
Simone Rodriguez — Leader, Health Sciences Strategy Organization, Cognizant[00:34]
Thank you for having me.
Rohan Kulkarni — Healthcare Practice Leader, HFS Research[00:34]
Over the last six months, HFS Research and Cognizant collaborated on a unique and connected study to understand three key attributes in the healthcare ecosystem: the impact of accelerating vertical integration in healthcare over the last three years, the implications of the payer-provider divide, and the potential of GenAI in healthcare to separate myth from reality. In that context, we surveyed over 350 payer and provider C-suite members and senior leaders in developing critical insights that were both surprising, yet validating our understanding of US healthcare. So, Simone, let me ask you, what were the top three insights that resonated with you?
Simone Rodriguez — Leader, Health Sciences Strategy Organization, Cognizant[01:16]
Yeah, thank you, Rohan. The first finding that really stood out to me was that 60% of health plans and health systems candidly admit that they do not have a robust understanding of their evolving member or patient needs. But despite that, they claim that they have the digital capabilities to meet those health consumer needs, and they’re making large investments to address those. The second is the recognition by 90% of payers and providers that without addressing the disconnect between them, delivering improved health outcomes for members or patients will remain unattainable. And while they don’t agree on the driving force behind the disconnect — regulatory, or data integrity and interoperability — about 70% of payers and providers do assign addressing their operational divide as their highest priority, and they believe implementing modern technology is the answer. And that brings me to my third insight. There’s a lot of enthusiasm around advanced technologies and their deployment in healthcare, particularly with generative AI. About half of health plans and health systems anticipate investing about a million dollars to $10 million over the next two years in GenAI, and some have already embarked on those investments. So despite all of the hype and urgency, only 20% of payers and providers have a vision for GenAI and its use within the organization. So there’s more work to be done to lay out an enterprise-level strategy for the deployment of GenAI and advanced technologies. But those are only three of several insights that came out of this survey. So Rohan, what are the top three insights that stood out to you?
Rohan Kulkarni — Healthcare Practice Leader, HFS Research[03:08]
Absolutely. It is interesting that, for me, despite the significant acceleration in vertical integration — where almost 50% of payers have either purchased or are buying providers, PBMs and other healthcare entities, and 35% of providers are creating health plans or are acquiring services — it is clear to me that bigger is not translating into better outcomes. In fact, we can make the argument that vertical integration may have translated into financial integration for the enterprises, but the underlying parts of the businesses remain and operate separately, making it perhaps more expensive as the choices have declined, but it has definitely impinged negatively on the health outcomes. Number two, payers and providers need a lot of help in understanding the capabilities of GenAI and the possibilities for their businesses. In fact, in our analysis, Simone, out of the 360 use cases that we analyzed, only 20% of them had any connection to GenAI. That aligns well with one of the insights that you provided in terms of the vision that payers and providers have. Only 20% of them have a vision at this point in time, right? So it leads me to believe that there is an expectation in the market, especially within healthcare, that GenAI can cook breakfast for you, but in reality, all it can do is create a new recipe at best. And number three is the approach payers and providers are taking to addressing their consumer needs. The top three pathways for payers are through acquisitions, partnerships, and a hybrid of in-house and partner development, while providers take a diametrically opposite approach, with their top three paths to meeting patient needs being through different flavors of outsourcing. So definitely loads and loads of insights that we captured, and I’m glad you were able to share some of those that resonated with you. So let me ask you, in terms of all of these insights that we’ve captured, what is that one takeaway, or advice even, that you would leave with our audiences?
Simone Rodriguez — Leader, Health Sciences Strategy Organization, Cognizant[05:23]
Yeah. So when we look at the population, there are five generations in the US workforce today, and they all have their unique set of healthcare needs, behaviors, and level of tech adoption. And despite these generational differences, healthcare resorts to this one-size-fits-all approach that is very reactive. We use medications and treatments to slow disease progression rather than proactively managing an individual’s health. And as a result, the Triple Aim metrics are going in the wrong direction. So one piece of advice that I have for health plans and health systems is to develop a strategy that puts the individual back at the center of care — taking generational differences and genetic and social determinants of health insights into account to deliver improved health outcomes and move the needle in the right direction toward achieving that Triple Aim of care. And we can leverage advanced technologies such as GenAI to enable this redesigned paradigm for healthcare. So that is my tick-and-tie key takeaway for this survey, Rohan.
Rohan Kulkarni — Healthcare Practice Leader, HFS Research[06:40]
Excellent. Putting the individual back in the center — I couldn’t agree more with you, Simone. Thank you very much. Really appreciate chatting with you and sharing these insights with our audiences. Thank you.
Simone Rodriguez — Leader, Health Sciences Strategy Organization, Cognizant[06:40]
Great. Thank you, Rohan.
