Enabling the Future: Modernizing Core Administration Systems – Planning a System Implementation, an HTMS whitepaper

As a result of healthcare reform, consumer driven markets, and other industry transforming dynamics, many health plans have found they cannot support their current and future operations with their current core administrative systems. While this rapidly changing environment presents many challenges— including medical loss ratio caps and the operational and technical requirements that could be mandated for plans that participate in Health Insurance Marketplaces (HIMs)—it also creates significant opportunities. Health plans must ensure their transactional systems are robust, efficient, flexible and based on an extensible architecture.

Organizations know that replacing a core system is a significant undertaking, and most make good faith efforts to plan and prepare accordingly. Nonetheless, it’s easy to underestimate the degree to which these projects will affect all aspects of the business and the inherent risks associated with such endeavors. A core system implementation or replacement project is truly an enterprise-wide business and technology transformation initiative. Most organizations that have lived through a core system modernization agree that the effort was, in hindsight, much more challenging, expensive and time-consuming than anticipated. Read the full whitepaper

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