By Calvin Glenn-Oracle on Oct 21, 2015
Healthcare in Latin America is undergoing significant change. Many factors are influencing these changes. Age, chronic disease and increasing wealth in some countries are creating a new demand for higher quality services. Governments are increasing spending, and local and multinational private sector players are investing heavily.
Kathy McCarthy, Director of Sales Consulting for Oracle Health Insurance, discusses the topic in today's post.
Legacy IT systems that resist change make it difficult for health plans to capitalize on new opportunities. Custom development is a costly and cumbersome approach in a business where competitors change tactics overnight. Health plans require greater agility to address their specific business requirements and adapt in real time to ever-shifting market conditions.
Latin American health plans need flexibility as a central IT platform design component. They require applications that support core business processes where people may choose a private health plan as a supplement to, or in lieu of, public insurance – ultimately supporting business innovation and rapid growth.
Factors such as budding economies, up-and-coming middle class, and progressive policies toward managed care make it hard for public systems to keep pace. As the population becomes wealthier due to economic growth, more Latin Americans will choose to enter a private healthcare system.
The influx into the private healthcare system opens significant opportunity, and it also presents several challenges. Health plans must deal with regulatory and contractual complexities that are unique to the sector, such as waiting period requirements, co-pays, and the negotiation of in-network versus out-of-network agreements. They must also have the scalability required to process a high volume of claims.
Health Plans will be well-served in the short- and long-term by moving forward with their own game plans for success in a new era of healthcare finance and coverage. There are several strategies that health plans can put into action today that will serve them well – now and in the future – regardless of how the health plan market continues to evolve.
Plans need to consider that:
- Cost efficiency is paramount. Most insurers are expecting to reduce the costs incurred for healthcare with technology.
- Systems need to be agile and flexible to handle legislative changes and market demands.
- Security and privacy of health data is an integral element of any system.
- Data becomes critical to manage costs and outcomes. There must be access to data and the ability to analyze and manage that data.
If you are an insurer that is looking to expand into Latin America market or currently competing in the health insurance market in Latin America then you should download the new “Health Insurance in Latin America” white paper to learn some of the ways to build competitive differentiation to be successful in this market.
For more information on Oracle Health Insurance, visit oracle.com/insurance.
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