One thing is certain in today's healthcare payer community - change.

Payer organizations are facing broad, deep and significant change like never before.  While some dimensions of healthcare reform remain uncertain, several are approved and have approaching deadlines:

• Implementation of government mandated Medical Loss Ratios (MLR)
• 5010 Compliance
• Transition from the ICD-9 to the ICD-10 standard
• Health Insurance Exchanges 

These mandates, coupled with ongoing scrutiny and pressure on payers to reduce consumer costs, adapt products, and improve operational efficiency, creates an environment where only the prepared and nimble will survive.  The biggest challenge now is how an organization adapts to this change in order to thrive.

The most significant predictor of a payer’s capacity to adapt to change will be their ability to become technologically dynamic.

What does this mean? Payers must harvest the skills to be continually adaptive, ready for change, and agile in executing strategies. To remain static in this environment is no longer an option.

Are you “Technologically Dynamic?”

• Are you prepared to respond to pending regulation or reforms? 
• Are you losing money through inefficient processes and under-utilized technology?
• Have you implemented technology solutions that failed because you didn’t execute a change management program?
• Are you operating multiple platforms and are unable to get a “single source of truth” on how your enterprise is truly operating?
• Does your customer experience support the acquisition and retention of clients?

West Monroe Partners can help your organization succeed
 
West Monroe has the necessary insight and deep industry knowledge to move your organization forward – even in the face of major change.  Our hands-on experience in leading significant technology initiatives and business transformation will not only guide you through the changes you face today, but position your organization for success in the future. This experience combined with our inherent disposition for driving change will help your organization to:

• Prepare for and implement systemic, process, and organizational changes related to HIPAA 5010 and ICD-10 regulations
• Optimize operational processes to increase staff productivity and reduce IT spend to increase MLR
• Consolidate claims and platforms to simplify operations and allow flexibility for growth (merger, acquisition, new clients)
• Improve fidelity of benefits information across the enterprise to eliminate manual touches of data and increase claim payment precision
• Drive growth by improving overall customer experience and satisfaction
• Increase percentage of auto-adjudicated claims processing
• Improve customer satisfaction by providing clients with real-time data reporting