5 Keys to Help Your Health Plan Focus on 2020

Aug 27, 2019

No crystal ball needed. Here’s what we see successful health plans doing now to prepare for 2020.

It seems like once Labor Day passes, we prepare for the last half of the year no matter what the weather does. Pumpkin everything, dreams of cooler weather and … 2020 business planning. That’s pretty much what September will look like for many of us. This is the time of year when many organizations are thinking about the year ahead: making budgets and conducting strategic planning sessions. Where is your health plan heading, and are you looking far enough into the future?

Here are 5 key things health plans should consider as they plan for 2020. 

1. Start with last year’s plan

You’ve done this before — last year, in fact. There’s likely no need to reinvent the wheel as you plan for 2020 (though you may have some new ambitious goals). You can start preparing for next year by looking at your plan for this year and identifying what you know has worked and what hasn’t. Long-term planning in an industry that’s poised for disruption can be tricky, but we know there are a few persistent trends that can be addressed in your business plan:

2. Keep your long-term plans flexible

Disruption is knocking and plans that are inflexible won’t survive the future. You may not be able to plan for every specific change headed your way but you can plan for change. Flexibility is essential to ensuring the long-term plans you make are able to adapt to the coming changes in technology, business models and regulations. 

One business strategist says, “For any given uncertainty about the future — whether that’s risk, opportunity, or growth — we tend to think in the short- and long-term simultaneously.  I build a cone with four distinct categories: (1) tactics, (2) strategy, (3) vision, and (4) systems-level evolution.” Instead of a linear, timeline view — which perpetuates a cyclical tactic-strategy approach — a time horizons “cone” allows you to be more flexible, consistently poised to be ready for whatever the future brings.

3. Avoid the pitfalls of linear, short-term thinking

So, you can’t prepare for every aspect of the future. But that doesn’t mean you should avoid it. Short-term thinking can hinder long-term growth. Making decisions based on immediate needs will not serve you best moving forward. This particularly affects health plans when it comes to recoveries. Health plans may settle for less than what they could be getting because they are hesitant to invest in technology or expanding their vendor footprint because of cost. 

We understand this way of thinking; sometimes it feels like the only way to survive. But saving the tree, only to lose the forest is a mistake health plans can avoid. You may be able to get by with legacy technology and outdated processes for now, but investing capital in innovative technologies can set you up to thrive into the future. 

4. Prepare for innovation cycles

Deloitte’s paper The Health Plan of Tomorrow urges health plans to recognize and prepare for the coming disruption or “innovation cycles,” which they caution happen not all at once but often incrementally. Rather than wait for a huge sign, Deloitte advises health plans prepare now for “radical transformation” by: 

Transforming business models

“In the future, only plans that break down internal constraints holding them back will have survived,” cautions the paper. It’s important for leadership to accept and communicate impending transformation. 

Investing in dynamic technologies

It’s true, legacy technologies have held health plans back. Now’s the time to shift focus (and capital) to futuristic technologies such as: AI and analytics, automation, blockchain, and cloud computing. 

Workforce training and talent

Business transformation means employees will need to be trained in order to use new technologies efficiently. Furthermore, new talent will need to be acquired as new skill sets are required. To support these changes, health plans will be better served by shifting their workforce structure. “Data and analytics teams will no longer be housed within individual functions supporting only one market. Instead, they will sit across functions, feeding data from a multitude of sources to support care and claims teams.”

Dynamic data governance policies and practices

There’s going to be an enormous amount of data to manage in the future, and this requires a “strong data governance philosophy of data acquisition, management, and security,” says Deloitte. Our industry is working quickly to identify and agree on universal standards like Fast Healthcare Interoperability Resources (FHIR), but we aren’t quite there yet. Standards need to be flexible and able to quickly pivot based on new trends in order to survive in the future. 

Risk management

Health plans will rely more heavily on data in the future, which means the need for accurate data is vital. Risk always comes with new business models but in an industry undergoing disruption, it’s essential to closely monitor current risks and predict future ones. Paying attention to regulatory and compliance changes and accepting the evolutionary nature of such policies and plans will be key for health plans. 

5. Master these two skills essential to futurist planning

There are two interpersonal skills that translate well into futurist planning: learning to become a change agent and developing a community mindset. A change agent is “a leader who has the skills to navigate an organization through change management initiatives.” Understanding that change management may be a broader objective at your health plan, consider how equipping leadership with change agent skills may further your goals. 

Secondly, health plan leaders should embrace a community mindset. It’s time for health plans and other stakeholders (like providers and technology vendors) to come together and support one another on initiatives. Shared knowledge is a powerful component of community but there are also professional benefits in finding a support system. It’s easier to plan ahead for the future when we converse with other stakeholders regularly and can understand broader, universal challenges and opportunities facing our industry.

Talk to ClarisHealth about how Pareo®advanced payment integrity technology is helping health plans stride confidently into an uncertain future.

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