Overview
Today’s fragmented healthcare data ecosystem is growing more complicated. If you’re an IT leader in a health plan or third-party administrator (TPA), you’re tasked with managing data integrations with a host of vendors and point solutions.
Recognizing the trend of exploding choice amid rising administrative and technical barriers to meet this demand, revenue and product leaders are creating curated marketplaces to control variations their customers may demand. They’re also seeking opportunities to commercialize these marketplaces to other payers. Both are high-priority initiatives for IT leaders. But they’re not the same. While a marketplace for existing clients involves a relatively straightforward approach to managing data integration, offering marketplace options to other health plans and TPAs often rises to the top of the priority list because it generates new, diversified revenue. In doing so, integration challenges could actually be exacerbated by layering additional hierarchies and data requirements of other businesses and groups.
At Flume, we designed our platform to help ensure seamless and efficient data integration for payers and third-party administrators (TPAs) connecting with dozens of solution providers, both stand-alone and through marketplaces. We’ve recently enhanced it with Custom Business Objects - a tool that enables payers, TPAs and even marketplaces themselves to manage simple and quick integrations performed by non-technical staff.
Launching a solution marketplace
Marketplaces are part of the bigger trend of offering benefits through companies that aggregate and curate the hundreds of digital health and digital therapeutics solutions available today.Marketplaces connect these solutions to employers, health plans and TPAs. While the concept has been around for years, it’s picking up steam as more companies look to offer progressive, personalized benefits while holding the line on rising costs, tied to unclear return on investment and administrative burden. “As summer begins to heat up, digital health solution aggregators are competing for pole position with employers and health plans,” Michael Pace, CEO of PalmHealthCo who regularly publishes an aggregator market map, wrote in a recent LinkedIn post.
Notably, payers and TPAs are now launching their own marketplaces to either serve their employer groups or create a service they can sell to other payers and TPAs. Either approach opens up new data integration challenges. When launching a marketplace, the more benefits solutions a payer or TPA offers, the more complex the data integration task becomes. Of course, complexity is reduced by limiting choice, but that doesn’t solve for the many ways that specific employer groups want specific solutions - each with its own data standards and formats.
Want more complexity? Try commercializing these curated marketplaces outside your walls. Instead of just integrating data between benefits and groups, now you’re doing so for other payers and TPAs - and their groups. Such an approach helps monetize your effort in curating, qualifying and setting up these point solutions. It’s a reasonable strategy to enhance product design for attracting or retaining employer groups, but it requires careful attention to how you manage data exchange.
Benefits of using Flume
Flume is the first data integration platform designed specifically for health plan administration. The solution systematizes the complex process involved in establishing connections with a variety of sources and destinations of administrative data that are required for members to use their health benefits, typically resulting in cost savings of 80% to 90% on integration setup and maintenance.
Flume customers - payers, TPAs, vendors and marketplaces - also save considerable time, as integrations are whittled to days instead of typical six- to eight-week implementations. Data integrations through Flume and its Custom Business Objects feature enable marketplaces to come to life with minimal investment.
Key features
- Custom Business Objects: Our newest feature offers the ability to instantly connect a health solution to specific employer groups, populations or products with just a few clicks; non-technical users can easily add and delete groups, lines of business, health plans and products within the platform
- Canonical structure (not point-to-point) for automated, secure bidirectional data exchange
- Works within your existing existing data schema and systems; health plans use their native data format, and marketplaces and vendors use theirs
Expected outcomes
For health plan CIOs, CTOs or COOs, Flume can deliver significantly lower marginal integration costs and greater speed and simplicity when launching marketplace solutions. And you can manage integrations within your existing charter as an IT leader, leading to budget protection for strategic priorities.
