August 20, 2014 | By Rey Villar
This spring we surveyed industry leaders and decision makers at health plans across the country to better understand how the Affordable Care Act and the post-reform environment are changing the way plans make decisions.
Our survey offered new insights into how health plans are responding to the challenges they face in the post-reform world.
Where are plans making investments in response to the ACA and what do those investments mean about organizational changes?
These results indicate that more than half of the health plans surveyed are concerned about their capabilities with provider cost and quality metrics, consumer engagement models, and care management analytics solutions, and are making investments in response to the ACA.
We believe that these solutions are critical to the success of health plans going forward. We’ve helped several leading plans develop provider cost and quality metrics, consumer engagement models, and care management analytics solutions, and our team of specialists has an excellent track record of implementing solutions that drive success in each of these areas.
Do plans have data strategies in place and how will these strategies shape their data and reporting in a post-ACA environment?
These responses illustrate an issue the Ajilitee team sees frequently: only 36% of health plans consider their data strategy well-developed. At Ajilitee we believe a comprehensive information management and analytics strategy is critical to success in the post-reform era.
Health plans that can effectively leverage internal and external information to generate insights that optimize revenue, reduce expenses, and improve the quality of care will be poised for success in this new environment.
Which areas will your organization invest in over the next two years in response to the ACA?
Although 72% of plans indicated they are prepared or very prepared for the Affordable Care Act, 98% of plans indicated they will be making investments in one or more of the following areas:
These responses indicate that while the majority of health plans feel prepared for the ACA, there is still a significant amount of work to be done to build out the business capabilities they will need in the post-reform marketplace. Ajilitee has focused expertise and a proven record of helping plans develop market-leading solutions in provider data management, consumer engagement, and care management solutions.
Check out the brief video below to understand the information, data, and technical challenges faced by health plans in the post-reform world — and what is needed to succeed.
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