Improve Outcomes and Experiences by Transforming Your Data
The Situation: The healthcare industry continues to transform and reinvent itself as it faces new mandates, competitors, and customer expectations. Market changes include increased M&A activities; a greater proportion of patients covered by Government reimbursement (Medicare, Medicaid); lower reimbursement rates; employers moving towards “narrow network” plans to control costs, and high deductible plans.
Consumers (patients, employers, and payers), as a result, are demanding more transparency in billing as the costs from payers and providers rise.
The solution – an innovative patient-centric focused delivery model based on transparency, quality of information, and timeliness.
The Impact: The Techstra team created a comprehensive, data transformation strategy aligned to an industry maturity model that enabled member, provider, and patient experiences supported by next-generation technology. The level of change required to achieve the target state was identified across people, processes, and systems.
- Developed user journeys to create a patient-centric perspective of health plan operations
- Mapped end-to-end data lifecycles
- Enabled outcomes with data models and data management standards