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New Approaches to Member
and Provider Care Coordination
Challenges
The right technology can help health
plans push forward and deliver new,
innovative solutions that satisfy their
providers and members.
However, legacy architecture and siloed
information still remain a challenge.
Disruptions continue to challenge leaders to:
deploy the necessary
technology to support
their key initiatives
reimagine and
reinvigorate their
business models
How do payers push forward in an era of...
rising costs,
market disruption,
and mounting member expectations across
the care continuum?
Health IT challenges
Top of mind for Healthcare
CIOs is finding new technologies
and ways of delivering better
experiences for members and
providers.
Challenges include:
These challenges are not new, but as digital solutions
come into play, even more challenges pop up,
and will persist for many years to come.
Increasing demands for lower costs,
better access to care, transparency,
and personalized services and experiences
Unsustainable, high cost of care
Pressure to operate more efficiently
and perform more intelligently
What's new?
Healthcare payers’ options for meeting these challenges
has changed.
Having the right digital transformation solution implemented
or in the near-term roadmap will differentiate savvy health-
care payer organizations from those who get left behind.
New approaches to care coordination
To better serve members and providers
across the digital care continuum,
healthcare organizations are increasingly
turning to an agile platform approach to
application development.
A platform approach
It aggregates all data from across systems and
connects health devices into one interface to
give payers the right information at the right
time.
This approach is allowing them to process
claims correctly for providers the first time,
and coordinate the most appropriate and
personalized care for members.
This saves time and money that is currently
being spent on manual processes
and potential errors.
The Appian platform
The Appian platform for
healthcare can break down
silos and tap into various data
sources, including blockchain,
to provide complete, actionable
views of relevant data.
Process automation
Appian’s leading process automation
capabilities, turbocharged by robotic
process automation (RPA),
intelligently streamlines important
steps across the care continuum,
such as prior authorization
processes, increasing external
satisfaction and internal efficiency.
Championing transformation in healthcare
Healthcare organizations across
the United States are embracing
the powerful platform approach
that Appian offers.
Take the example of AIM Specialty
Health (AIM), a benefits management
organization with over 50 million
members.
AIM
50 MILLION
MEMBERS
One unified interface
Using the Appian Platform,
AIM is consolidating eight
systems into one unified
interface that increases
data visibility into their
core operations.
Appian can help your
organization navigate
the digital care continuum
to better serve
members and providers.
www.appian.com/new-approaches
appian.com/new-approaches

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New Approaches to Member and Provider Care Coordination

  • 1. New Approaches to Member and Provider Care Coordination
  • 2. Challenges The right technology can help health plans push forward and deliver new, innovative solutions that satisfy their providers and members. However, legacy architecture and siloed information still remain a challenge.
  • 3. Disruptions continue to challenge leaders to: deploy the necessary technology to support their key initiatives reimagine and reinvigorate their business models
  • 4. How do payers push forward in an era of... rising costs, market disruption, and mounting member expectations across the care continuum?
  • 5. Health IT challenges Top of mind for Healthcare CIOs is finding new technologies and ways of delivering better experiences for members and providers.
  • 6. Challenges include: These challenges are not new, but as digital solutions come into play, even more challenges pop up, and will persist for many years to come. Increasing demands for lower costs, better access to care, transparency, and personalized services and experiences Unsustainable, high cost of care Pressure to operate more efficiently and perform more intelligently
  • 7. What's new? Healthcare payers’ options for meeting these challenges has changed. Having the right digital transformation solution implemented or in the near-term roadmap will differentiate savvy health- care payer organizations from those who get left behind.
  • 8. New approaches to care coordination To better serve members and providers across the digital care continuum, healthcare organizations are increasingly turning to an agile platform approach to application development.
  • 9. A platform approach It aggregates all data from across systems and connects health devices into one interface to give payers the right information at the right time. This approach is allowing them to process claims correctly for providers the first time, and coordinate the most appropriate and personalized care for members. This saves time and money that is currently being spent on manual processes and potential errors.
  • 10. The Appian platform The Appian platform for healthcare can break down silos and tap into various data sources, including blockchain, to provide complete, actionable views of relevant data.
  • 11. Process automation Appian’s leading process automation capabilities, turbocharged by robotic process automation (RPA), intelligently streamlines important steps across the care continuum, such as prior authorization processes, increasing external satisfaction and internal efficiency.
  • 12. Championing transformation in healthcare Healthcare organizations across the United States are embracing the powerful platform approach that Appian offers. Take the example of AIM Specialty Health (AIM), a benefits management organization with over 50 million members. AIM 50 MILLION MEMBERS
  • 13. One unified interface Using the Appian Platform, AIM is consolidating eight systems into one unified interface that increases data visibility into their core operations.
  • 14. Appian can help your organization navigate the digital care continuum to better serve members and providers. www.appian.com/new-approaches