安永&KLAS：2023付款人技术研究报告（英文版）（21页）.pdf

1、The 2023 EY-Parthenon and KLAS Research Payer Tech Study2The 2023 EY-Parthenon and KLAS Research Payer Tech Study|The 2023 EY-Parthenon and KLAS Research Payer Tech Study highlights Cost optimization is the top strategic priority for 70%of health insurance payers as their profits face pressure from

2、deferred patient activity,increasing competition and an ever-changing regulatory landscape;driving growth via growing market share and business diversification were also noted as key strategic priorities.Payers plan to increase their member centricity using a combination of tech and services,while a

3、lso leveraging their health care IT(HCIT)solutions to optimize medical and administrative costs,comply with shifting regulatory requirements and diversify revenue streams.HCIT solutions with a through line to revenue and costs are expected to see increased investment;45%of payers expect risk adjustm

4、ent,condition management and payment integrity solutions to be“highly significant”areas of investment.Third-party vendors are an integral part of these operations currently,with 80%of payers outsourcing a portion or all of their workflows across functions.Occasional insourcing,typically for larger p

5、ayers,points to increasing sophistication on in-house capabilities,which payers intend to leverage to pursue avenues for revenue diversification.Interoperability,reporting analytics and ease of use are top-of-mind vendor selection criteria in the current state.Payers are cautiously optimistic about

6、adopting differentiated generative AI(GenAI)capabilities within their HCIT solutions in the next two years.HCIT vendors need to showcase reliable,traceable outcomes simply having artificial intelligence(AI)and machine learning(ML)capabilities is not going to impress potential clients.IntroductionEvo