Health Plans

Payers and providers should re-evaluate their digital strategy to prepare for the future

May 19, 2020 | Article | 4-minute read

Payers and providers should re-evaluate their digital strategy to prepare for the future

In our previous post, we shared how the COVID-19 crisis is likely to affect health organizations in the medium to long term. We suggested that virtual care, or telehealth, will become a universal phenomenon. In the past few weeks, payers took multiple actions to enhance telehealth adoption, but much more can and should be done to support the long-term viability of telehealth.


In the near term and just beyond the crisis, payers could explore reimbursement parity for in-person and virtual visits, integrate telehealth data with EMR and lab data and expand beyond e-checkups to effective home care and virtual behavioral health check-ins.


While pursuing these initiatives, however, it’s imperative that health organizations accelerate their long-term enterprise digital strategy to achieve their virtual care objectives. Given the disruption caused by the current crisis, health organizations should evaluate all digital strategic initiatives to either drive growth or create value from a cost of care and efficiency perspective.


We believe that chief digital officers (CDOs) should focus on the following strategic imperatives in close collaboration with their CEO to accelerate enterprise digital strategy.

  1. Evolve your road map. Take a structured approach to re-engage, reassess, respond and reinvent in order to take your digital road map to the next level. Start by re-engaging with members and listening to social media to understand their member’s needs. Reassess the value and feasibility of your digital road maps and related strategic plans based on your understanding of members’ priorities and preferences. Respond to your members’ needs and re-invent your digital strategy with agility. A revised, agile road map should be re-evaluated on an ongoing, periodic basis, for example, once per quarter or twice per year.
  2. Prepare for the unknown. Use a well-defined use case prioritization framework to identify relevant digital initiatives from both a strategic and tactical standpoint that can be employed to manage ongoing challenges to your operating environment. For example, one of our health plan clients prioritized the implementation of a chatbot to handle a sudden spike in call volume to their call center. This is a tactical initiative, yet it was relevant and timely for their operating environment. A cross-functional team of digital experts can help you respond to ongoing challenges by taking prioritized use cases through an agile development process. We recommend leveraging an iterative “learn, test and learn” process to help you quickly scale successful experiments across the enterprise.
  3. Modernize your infrastructure. Loosely integrated technology and siloed data sources across departments pose a significant barrier to scaling virtual care, so it’s important to modernize your technology infrastructure in the long-term. It’s also a time consuming, investment-intensive process, so it’s critical to apply a tech investment lens during the road map re-prioritization process for high impact, strategic use cases, not afterward.
  4. Become agile and user centric. Discover and scale your prioritized use cases at the pace of the crisis based on member and employee experience with your technology offerings. Continue to learn, scale and test with a continuous feedback process.
  5. Invest in your team’s adaptability. Partner with human resources to leverage online training programs. It’s essential to provide continuous learning opportunities to your digital team members so that they can adapt to the many changes your business is facing and will continue to face. Prioritize remote boot camps and workshops in a collaborative learning environment for your digital team, especially those that focus on work-from-home models.

We recommend that CDOs pursue these imperatives while holding fast to some guiding principles: Health organizations should partner effectively with outside organizations to bring this “digital first” journey to life. Online channels should be designed around simplified, streamlined, value-adding member experiences driven by digital technology and data. Finally, the member experience should be seamless and friction free across the entire business process.


Health organizations should move forward and achieve progress while moving at the speed of trust. Patients and members have a trusted relationship with their physicians and providers. It’s hard to switch from an in-person care visit with a “trusted advisor” to a virtual care environment. A large-scale adoption of virtual care can only be achieved by having an empathetic view towards members. It will take time to build trust with continuous, sustained ethical innovation.


Digital can no longer be an afterthought. Patients and members expect the same digital experiences from healthcare that they encounter in every other sector of the economy. Payers and providers do need to accelerate their digital implementation with agility and resilience and achieve success in weeks and months instead of years. This will require a much-needed mindset shift.

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