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Predictions for the health care payer market for 2008: The rise of integrated health care management.

Article Excerpt
As we begin 2008, the health care industry is entering a new era of integrated health care management--the systematic application of processes and shared information to optimize the coordination of benefits and care for the health care consumer.

Payers are ideally positioned to lead the way toward this new model, and the move is already getting started within some of the more innovative organizations. These payers are implementing systems and processes that drive the convergence of core administration, care management, and constituent-engagement approaches through interactivity, information, and incentives.

Multiple powerful forces, all of which will intensify in 2008, are prompting this. For example, growing demands for improved coordination and quality of care require that payers gain a comprehensive view of individual members, share this with providers in a timely way, communicate more directly with members, positioning them as informed consumers. Clearly, this necessitates the integration of systems and related processes that support core administration, care management, and communication among all relevant constituents in the health care supply chain.

Meanwhile, competition with financial services organizations is intensifying, heightening the need for payers to implement systems that differentiate their ability to serve the whole person, as opposed to focusing on transactions.

Other trends also will change the landscape in the year ahead. The push for universal health care coverage will present complex demands to state governments as well as the commercial payer organizations that provide coverage to residents. Ubiquitous access to the...

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