Payers: Unlocking the Power
of the Cloud

We are at an inflection point. For most payers, the question is no longer if they will move to the cloud, but when. There is also increased collaboration between payers and hyperscalers, among them Amazon Web Services, Google Cloud, and Microsoft Azure, to ensure that all stakeholders, including providers and members, benefit from this journey.

Not surprisingly, such efforts are not without risk, nor are they immune from the complexities of healthcare that demand a highly nuanced approach to technology and business transformations. Such efforts require a frank appraisal of issues that have shaped payers’ IT efforts in the past and the ones to come in the future.

Payers’ IT infrastructure today reflects the ongoing demand for an effective data strategy

While no two organizations are the same or have identical IT systems, the core infrastructure relied on by most payers today reflects the longstanding demand for an effective data strategy able to address two imperatives. These are: (1) the ongoing data deluge in healthcare; and (2) the direct impact this data has on important business outcomes.

Neither imperative is new. Even before the advent of IT, when teams of actuaries manually calculated premiums, payers were always dependent on data. To wit, in 2006 – the year Apache Hadoop was introduced – Clive Humby, the British mathematician, coined the phrase “data is the new oil,” a sentiment others would expand on to include that like oil, data also needed to be refined to use it effectively. 

Today, when business intelligence tools are ubiquitous across industries and used to organize and visualize vast amounts of information to make informed decisions, the importance of gathering, consolidating, cleaning and effectively using data needs no introduction, nor can its relevance to practically every business function for payers be overstated.

Few industries reflect the dramatic increase in data volumes or its importance like healthcare. Nearly everyone in healthcare must share information internally and externally to do their jobs. It is literally the lifeblood of most organizations, including payers. 

And it’s increasing in volume every day, whether in the form of 3D mammography images 20X larger than their 2D predecessors, video for telehealth, or the electronic health records used in practically every clinical setting. Simultaneously, gains in innovations like genomics and personalized medicine promise to create even more data, even as the number of wearables and other connected devices that relay a never-ending stream of information grows. 

It was this reality that prompted RBC Capital to note last year that 30% of the world’s data was being generated by healthcare. It also predicted it will increase by an annual compound growth rate of 36% by 2025.

Just as importantly, the ability to use this data is also inextricably linked to payers’ successful completion of crucial business outcomes. These include growing customer satisfaction by creating member delight, future proofing core platforms, achieving operational excellence by transforming business processes, creating an effective analytics and machine-learning data platform able to extract actionable insights, and creating systems that protect data and inform stakeholders when threats are imminent.

Fortunately, the IT infrastructure used by most payers was created to address these imperatives. Unfortunately, in most cases it is no longer sufficient.

The active and expanding partnerships between payers and hyperscale cloud providers today promise to forever change payers’ businesses for the better while radically improving their ability to effectively act on data shared not just throughout the organization, but also with the providers they work with and the members they serve. By looking to the past, realistically appraising the present, and actively planning for the future, payers can proceed on the right cloud journey for them, with confidence.