Healthcare Reform Technology Tips for Payers, Providers

Payer systems of the future will need to be architected upon new enabling and efficient technology that is:

·         Rules-based and object-oriented. Rules-based, object-oriented architecture is the most flexible, efficient, and high performance way to build complex transactional systems, especially claims processing systems. Re-usable objects defined and configured by business users deliver innovation on the fly with minimum maintenance overhead and optimal system performance.

·         Scalable and Non-Proprietary. New systems must scale not only from a transaction volume perspective, but from an ongoing engineering perspective as well. Payer organizations will need to contain IT costs while expanding functional depth and breadth. This will require low cost, readily available technical resources that can be economically acquired and trained just in time.

·         Collaborative Software Development. Vendors will open their source code to their clients, taking advantage of the client’s subject matter expertise and skilled workforce. In collaboration, the vendor and the client will accelerate each client’s innovation agenda while minimizing associated engineering costs.

Real time, Web architected, workflow automated, across all lines of business and delivered through a collaborative open source code model, core payer administration systems for the future will enable rapid and efficient innovation. Speed to market with new products and services are the mandate for the next decade.

Scott Kornhauser is the CEO of Healthation, a leading provider of payer administration systems. He may be reached at: skornhauser@healthation.com