Proposed changes to the ACA aim to offer affordable quality health insurance, and curb the spending on healthcare in the US. Providing affordable healthcare for everyone will no doubt result in an increase of claims, putting additional pressure on claims departments.
A recent Healthcare Claims Executive study determined that 77 % of claims executives surveyed plan on investing in updated claims technology, rather than hiring new staff to deal with these impending changes. Only 5% of respondents plan on hiring new staff.
A recent State Street report showed that 86% of insurers are still challenged by legacy systems, with 93% stating that they need a new IT infrastructure to integrate and manage data. Legacy systems, historical data silos and manual processes are preventing insurers from improving their claims processing efficiency.

New competitors in the market are changing the competitive landscape by using data driven technology to transform the traditional insurance business model. Existing insurance carriers and TPA’s need to keep up to ensure they maintain market share.
According to a recent report by Forrester, cloud computing is increasingly being considered as a way for IT departments to reduce capital investments and operational costs through infrastructure rationalization. This report also found that only 7% of IT departments said they wouldn’t, or don’t plan on using cloud technology. Another 33% of respondents stated that they would consider using cloud technology for critical applications.
Cloud technology offers insurers a flexible and scalable solution that can easily integrate at multiple data points to create a single user system. This integration offers claims administrators a more efficient claims processing solution to deal with the increase in volume and complexity of claims over the next few years. To learn more about claim processing in the cloud click here.