Dec. 19, 2018
CEO Insight: Obstacle or Opportunity?
These are challenging times for healthcare payers. Increasing aging populations, pressure to cut costs, and a focus on quality is requiring everyone to do more with less. By facing these challenges head-on, we can turn these obstacles into opportunity. It is through continued innovation and experimentation that we will improve health care delivery in this country.

We believe the response to these three immediate obstacles will determine if an organization will thrive in the evolving healthcare landscape:
  1. Regulatory Compliance: What is your compliance strategy? Regulatory challenges and their impact on your operations is something you cannot ignore. With weekly, sometimes daily, changes being issued by CMS and state regulatory agencies, costly mistakes are common and can be fatal.
  2. Population Health Management: What tools do you have in place now and what are the next steps for your organization? This foundation will be important as we move away from claims data to clinical data. Important data like social determinants of health will be key in the future and solutions for small to mid-sized payers will be very different than their larger counterparts.
  3. Value-Based Care to Scale: The shift to value-based care is now and it's happening. Do you have a vision for how your organization will achieve quality outcomes? VBC is a big concept and the undertaking is a challenge for all small to mid-sized payers.
If you're stilling working on the answers to these big questions, then you're not alone. Many in the healthcare C-Suite are looking for answers and experimenting. There's not a one size fits all solution. Successful organizations are leveraging connections and networks of industry professionals to learn from others what has worked and what has not.

I want to wish all of HCIM's clients, affiliates, our fellow colleagues and their families a Merry Christmas, Happy Holidays, and a prosperous New Year.

Are You Considering Core System Replacement?
Outdated core legacy systems may hinder a payer's ability to respond rapidly in this evolving landscape.  In order to accommodate these trends and facilitate better integration and communication with customers and partners, many organizations are considering updating or replacing their core systems. However, switching to a modern core system comes with a number of challenges, due in part to the complex IT environments, custom surround code, and patchwork of legacy systems that characterize most organizations. Before making the decision to replace their core systems, organizations must first evaluate their existing core legacy systems and determine whether it still meets their business needs. Payers need to ask themselves, "Is a core system replacement really necessary at this point in time and if so, what are we going to gain by doing it?"
HCIM Colleague Spotlight: Kass Mahdi
Earlier this year HCIM welcomed Kass Mahdi to the team. In his role as senior director business development, he has worked closely with our clients to gain insight into their business needs. His 28 years of experience managing and supporting enterprise software implementation, business process improvement, strategic planning, business systems analysis, and client relations provides him with a deep understanding of the healthcare payer space. Mahdi has worked with all areas of health plans and human resources, under multiple IT deployment models and platforms. He has a successful track record of partnering with organizations to creating and executing strategy that leverages technology to support business goals.
 
To start the conversation, connect with  Kass on LinkedIn or contact him at  kmahdi@hcim.com.  

Have you met SymKey®?
Are manual processes bogging you down? Watch this 3-minute video to learn more about how SymKey® can help automate those mundane tasks so you can get the most from your core claims system.
 
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HealthCare Information Management, Inc. (HCIM)
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