Healthcare Payers: Are You Playing Defense or Offense?

Healthcare payers have a lot on their plates. Everything from staffing shortages to keeping up with changing regulations to meeting growth objectives leaves many health plans with little choice but to react to challenges rather than proactively solving them. Without the right resources, you’re often “putting out fires” and struggling to stay ahead of that next big demand. And with the ongoing talent shortage, you’re not alone in feeling like you’re constantly being asked to do more with less.

However, by rethinking the existing strategies you have around workflows, you can quickly move from playing defense to offense – while better preparing your organization for the unknowns.

A few signs that you’re playing defense

When you’re buried in work, you’re often solely focused on the situation at hand and too busy to invest much time, if any, anticipating and preparing for whatever may come next.

Here are a few signs that you have opportunity to change up your strategy and shift to a more offensive position:

  • Siloed workflows – Do processes feel like an assembly line, where each employee is head down, focused on a specific step? This approach gets the work done in the short term, but with any kind of pressure, such as growth initiatives, these types of workflows often become overwhelmed and break down.
  • Undocumented institutional knowledge – Do you have that amazing “go-to” person who knows all the legacy technology workarounds and how to solve tricky problems? This employee is a huge asset, but when they leave, all that knowledge goes with them. Make sure that kind of institutional knowledge doesn’t reside with a single person.
  • You’re #hiring – When you have to hire more people, like during periods of growth, it comes with its own challenges. First, you’ve got to find candidates with the right skills, and then, you must invest both time and resources to get them up to speed. You need resources that quickly scale up or down.
  • Audit anxiety – Do you feel 100% prepared to face an audit? Would you need to shift people around to meet the request on time? If so, how would doing that impact existing workflows? Leveraging technology helps with moving to a more proactive stance.

If any of the above sound familiar, continue reading to learn how technology helps you move to an offensive position while avoiding potential challenges.

Taking an offensive approach requires the right tools

Technology, like automation, allows you to streamline many processes that slow you down and reduce potential compliance risks. Not to mention, when technology handles the boring and mundane tasks, you free your employees to work on more rewarding and higher value assignments. A few things to think about when considering automation include:

  1. Identify the most time-consuming processes. Inventory your processes and identify the most time-consuming tasks. For example, if an employee takes an hour to create an incoming case and automation can reduce that to 10 minutes, that time savings can quickly add up.
  2. Avoid over-automating. Automation is a powerful tool to speed up workflows and support your employees while getting more done. But it’s important to automate the right processes. For example, clearly defined processes that don’t require decision-making are great candidates for automation. On the other hand, processes that have many variables and do require decision-making should stay with your employees.
  3. Choose a partner who isn’t afraid to ask questions. For example, if you tell your technology partner that you want to build something, you’ll want them to ask why you want it. A good technology partner has lots of experience and will meet such a request with questions before offering advice and strategies to make sure that request addresses the challenges you’re looking to solve.
  4. Seek training and support. Change is hard, and getting employees on board isn’t always easy. Working with a technology partner who provides excellent training and support helps your employees feel more comfortable and creates smoother user adoption.

Adopting automation is one of your best resources for moving from a reactive to a proactive approach. As a result, you’ll speed up workflows, support your employees while getting more done, and improve employee satisfaction. And with the right resources in place, you’re more agile and therefore, better positioned to navigate any challenges the future throws your way.