Legacy is History: Disruption at the Doorstep of Health Insurers

Health plans face the same challenges P&C, L&A, and other insurers have been wrestling with: core administration systems have become too big to fail. But now there’s a way forward, and healthcare is bringing up the rear.

If you’ve ever had the opportunity to visit a classic New England home, you’re immediately struck by the beauty and magnificence of a bygone era. The nostalgia captures your imagination, thinking about the families living there long ago. That is until you live in one yourself. The drafty windows, uneven floors, dirt basements, old plumbing, strict historic district rules… It’s truly a labor of love. But that shouldn’t have to be the case for the core administrative system at your healthcare insurance company.

As the former CIO and IT executive at several healthcare insurance companies, I look back and wonder what could have been — if only there were something better. We had to make sacrifices: the development of surround code to avoid touching our legacy application core; the functionality compromises made at the cost of customer satisfaction; settling for mediocre technology point solutions that created a sea of silos across the architecture. And let’s not forget the costs: the tried-and-true waterfall staffing model (business analyst/project manager/quality assurance/developer) applied to every project we took on, regardless of size.

We all wanted innovation and agility, but we had to work with what was available at the time. And while most of the technological world has moved forward, remarkably, legacy systems are still limping along today in healthcare. Good companies with great people have worked hard to make the best of the legacy technologies they’re stuck with. But each year, they cost more to maintain while they increasingly fall short of the business’ needs. Integration is far too complex and, maybe worst of all, they can’t support the customers’ journey.

In short, healthcare CIOs had envisioned a Tesla and were stuck with the Pontiac Aztec.

We watched all around us as technology continued to improve exponentially. But it isn’t so for our core administrative systems. We were forced to choose the cleanest shirt from the dirty laundry basket. Our aspirational RFPs met the hard reality of the vendor landscape. Our business partners needed better ways to compete, and they looked to us, the CIOs, to help them achieve it. Due to the timing of our decisions, we didn’t have the luxury of waiting for something better. We had to make it work with what was available. But what was available was setting us up for long term pain and expense. Our core administrative systems became too big to fail. They had become untouchable.

But what if it didn’t have to be this way? What if the technology for healthcare core administrative systems finally caught up to its potential? What if you could transform your entire technology stack in less than two years at a fraction of the cost? This isn’t a hypothetical scenario. The technology is here, and it is continuously getting better.

Microservices, containers, low-code/ no-code, configurable business rules, no-code UX persona-based apps, open APIs prebuilt to integrate with partners – all done in an Agile framework using CI/CD methodologies in a cloud-native environment.

For years now, EIS has been successfully deploying precisely that. A modern technology for insurtech companies like AFLAC, Liberty Mutual, Guardian, and so many others. But healthcare is different. Right? The insurtech world couldn’t possibly understand the complexities and nuances of healthcare. Could it? In fact, the foundations are essentially the same for all insurance types. The work left is to allow the business SMEs to configure what is unique to their needs.

It doesn’t have to be CIO suicide to upgrade your systems anymore. You can achieve what we’ve always aimed to: cost savings, speed to market, flexibility, all with the customer journey at the center of it, on a modern technology platform. The healthcare core administrative systems are ripe for disruption. It’s taking place in every industry, so why should healthcare be any different? At EIS we’re leading that disruption by creating an alternative to the traditional model and doing it at the speed of business.

Now you can look back on your legacy systems with the same nostalgia and charm you do when you visit a historic New England home. That’s because you don’t have to be the one to maintain it anymore.

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