A Platform-based Roadmap for Healthcare Payers

27 Feb 2020
by Abhishek Singh, Nitish Mittal, Kanika Gupta

Healthcare, as we know it, is changing rapidly. The key trends defining the industry include a seminal shift to value-based care, rise in consumerism, and regulatory uncertainty. As the industry navigates these changes, it also has to struggle with challenges such as siloed operations, fragmented member data, and legacy IT estates. With the emergence of digitalization, payers are realizing the undeniable need to leverage IT advances to deliver better care outcomes and remain competitive.

In this viewpoint, we showcase the current state of payers, the need to modernize, and the urgency of adopting an as-a-service IT platform model to enable true digital transformation. We assert that payers need to adopt this approach to help restructure their cost models and take a consumption-linked approach to modernization.


Industry: healthcare payer
Geography: US


In this paper, we:

  • Examine the state of payers across the financial distress and technical debt dimensions
  • Analyze the key challenges in the way of digital transformation and a suitable approach to transformation, and discuss the benefits of a platform-led approach and the relevance of affiliate partner models to navigate change
  • Solve the cost conundrum by outlining value drivers and a case-based analysis of different services models
  • Establish the business case for an as-a-service IT platform
  • Map the journey and institutionalize the roadmap for change


Healthcare IT Services (ITS)


Page Count: 21