Scott Polansky, Appian’s Industry Practice Lead for the Healthcare Payer Industry discusses digital transformation topics and trends impacting healthcare payers. Topics include customer behaviors, adapting an agile approach, the importance of a unified member view and accurate provider directories, as well as the current state of uncertainty amidst healthcare reform. Abby Jacobs serves as contributing host.

TRANSCRIPT:

Abby: Hello and welcome to the Appian Industry Outlook Podcast, where we take time to speak with Subject Matter Experts on digital transformation topics impacting their industries. I’m your host Abby Jacobs, a member of Appian’s digital marketing team and a self-proclaimed digital disruption evangelist.

Today, I’m joined by Scott Polansky, Appian’s Industry Practice Lead for the Healthcare Payer industry.

Thanks for joining us today, Scott!

Scott: Thanks for having me. It’s a pleasure to be here.

Abby: Before we get started could you tell us a bit about your background and your role at Appian.

Scott: I’m Appian’s Healthcare Payer Industry Practice Lead, where I help support the sales efforts around the country. Prior to Appian, I have 30 years of experience working for primarily Healthcare Insurers as well as doing some consulting business in a broad range of operational and strategic roles.

Abby: That’s quite an extensive background. I’m sure you’ve witnessed many changes in the healthcare industry over the years and how payers are changing the way they do business. What would you say are the biggest topics currently influencing customers behaviors for healthcare payers?

Scott: I think top of mind for customers is looking at greater flexibility and simplicity in product, benefit and network design. Consumers out there struggle with affordability. We called it the Affordable Care Act but it was really anything but in many instances.There’s also a tremendous lack of transparency around cost and quality, so those are the primary drivers. From the payer standpoint, they’re trying to figure out how they can better engage with their members to be able to drive better outcomes and quality of care.

Abby: From your experience, how are healthcare payers adapting to today’s digital economy?

Scott: It’s a spectrum out there. What we see is that those who are innovative and successful are adapting an agile approach to developing software and technology. They recognize that legacy systems do not provide the flexibility or speed to market so they are adopting new platforms to develop customized apps and integrate data from multiple disparate systems. Innovative payers are moving away from point solutions and towards enterprise platforms that enable the rapid development of customized solutions.

Abby: It goes without saying that adopting a customer-centric approach is essential for any organization in order to compete and deliver in today’s landscape. We’re witnessing a huge shift in what exactly that means and who exactly is a consumer across all industries. For healthcare payers, who are the consumers or stakeholders they need to keep happy and how are they able to do so in an agile way to meet growing expectations?

Scott: Payers have multiple stakeholders and they are trying to figure out how to simplify processes to create a better customer experience. It starts with the members who either come directly as individuals (retail) or through an employer. Often times a broker or consultant is involved and the plans need to meet their needs. Providers (facilities, physicians, medical professionals) are another critical stakeholder and the growth of value-based care will only intensify the need for cooperation and collaboration between providers and payers. Finally, the payer’s employees are critical stakeholders whose needs cannot be overlooked.

Abby: Now you spoke a...