Payer CIOs - Yes You Can!

A Payer in this economy is like the soccer ball - irrespective of who wins it always gets hit. Look at what a Payer has to deal with in this economy and new government

• Shrinking memberships - Follow the job loss trend
• Reduced Reimbursements - Less is more
• Higher Medical Costs - Physicians and Researchers never stop re-engineering the human body
• Operational costs - Can't keep them same while memberships and premiums are dropping
• Compliance Issues - ICD10 is an unknown animal

With all the above, here are the trends I see Payers are adopting to survive

• Shrinking Memberships - Lots of M&A Activity
• Reduced Reimbursements - Get intelligent on coverage but leads to unhappy customers
• Higher Medical Costs - Keep your members healthy, ask them to eat more greens and as Kaiser ad says it "Thrive"
• Operational Costs - Outsource, Offshore Outsource, Global Outsource
• Compliance - Treat it like Y2K, get it done in India cheaper

The glimmer of hope and light at the end of the tunnel is the $18B that Obama is planning to spend on E H R adoption. My thought is very simple, if Payers pay the physician practices and manage the provider relationships - why can they not capitalize the opportunity? So here is a crazy yet doable idea for CIOs - I am sure there are brighter folks than me who have figured it all out .. but none the less..

Payer CIO organizations can move from being a cost to a profit center !! Here are a few thoughts ....

• Payer CIO can work with a E H R vendor and define a physician package
• The Package can be sold using the physician practice relationships
• It is annuity revenue source - keep the E HRs supported and updated
• CIOs can provide some relief to their IT budgets if this can work

I am surprised that the only notable announcements on addressing the E HR investments came from eClinical Works , Dell and Walmart and no one else yet!! Now that I have blogged my idea for the day, I better get back to work. Have a fun day!