5 considerations for health plans evaluating the VOI of healthcare technology

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Article Summary: The adoption of new healthcare technologies carries risks for health plans, particularly when evaluating the value of investment (VOI). Health plans must consider operational efficiencies, regulatory compliance, and member engagement while adopting technologies. Failure to effectively assess and integrate these technologies may lead to operational disruptions, compliance issues, and suboptimal health outcomes.

The Risks:

1. New Technology Implementation: As health plans adopt AI and automation technologies for tasks like claims management, improper implementation or inadequate system integration could result in operational disruptions, manual errors, and increased costs, negating potential efficiency gains. (Area: Health Plan) (Category: IT Practices)

2. New Technology Compliance: Health plans must ensure that new technologies align with evolving regulatory requirements (e.g., CMS guidelines and state regulations). Failure to do so may result in non-compliance, which could lead to financial penalties and reputational damage. (Area: Health Plan) (Category: IT Compliance)

3. Member Engagement and Satisfaction: Health plans that fail to adopt effective member engagement technologies may experience dissatisfaction, low retention rates, and poor health outcomes, ultimately undermining their value-based care goals and financial sustainability. (Area: Health Plan) (Category: Membership)

4. New Technology Impact on Care: Adopting technologies that incentivize healthy behaviors (e.g., wellness visit incentives) is crucial to improving long-term health outcomes. Health plans risk inadequate adoption or misalignment of such initiatives, leading to missed opportunities in prevention and early intervention. (Area: Health Plan) (Category: Standards of Care)