Health plan providers and insurers are facing a rapidly changing healthcare landscape, with factors like outcome-based payment models, digital-first startups, regulatory changes, and rising healthcare costs playing significant roles. Data silos, regulatory compliance, claims management, and balancing cost and quality are key challenges in the industry. Digital technologies like AI, IoT, RPA, NLP, and digitization of healthcare data are being used to streamline operations and improve efficiency. Integration of digital tools is crucial for health plan providers to stay competitive. Experienced partners are needed to implement strategic technology solutions as the industry evolves. John O’Day, VP of Citius Healthcare Consulting, shares insights on navigating these challenges.
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