Point of View

Enable cloud-native and AI-powered healthcare digital platforms to manage rising costs, risks & demand

Healthcare digital platforms emerge as the “have-to-have” strategy for over 90% of C-level (CXO) health plan executives.

A “healthcare digital platform” is the integration of applications and emerging technologies to provide a tailored healthcare solution that drives business outcomes—a significant modern and accelerated approach to disintermediate legacy core administration processing systems (CAPS).

HFS Research, in partnership with Infosys, surveyed 100 CXOs at health plans across the US to learn about their key business objectives and the fit for a “healthcare digital platform.” Our survey revealed
several key insights:

  • The survey respondents listed reduction of administrative costs, better risk and compliance management, and supporting increasing demand as the top three business objectives that a healthcare digital platform can address.
  • As such, most healthcare CXOs believe that IoT, blockchain, and AI will play a significant role in driving the desired business outcomes from digital platforms. Cloud emerged as the “have-to-have” technology to deliver the desired business outcomes.
  • Despite the business imperatives and enthusiasm for adoption, fewer than 50% of the digital initiatives have scaled.
  • While there are several improvement opportunities across the health plan value chain, tech debt, quantifying value, and cultural change management are the key barriers to adopting digital platforms.
  • Recognizing that transformation will require investments, there is an opportunity to disrupt legacy health plan economics over the long term. In the meantime, payas-you-go and business-outcome-driven KPIs are considered the most important features for a digital platform to drive adoption and acceptance.

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