The healthcare industry, spurred by the demands of the pandemic, faces the critical task of overhauling outdated core systems. These legacy systems, many relying on antiquated languages like COBOL and VB6, are hamstrung by inflexible hierarchical databases unsuitable for the fluid needs of modern healthcare. Historically, healthcare payer CIOs have tried to update these platforms incrementally, but such approaches are increasingly insufficient.

The challenges amplified by COVID-19 have made clear the urgent necessity for comprehensive digital transformation. Consequently, there is a move toward rebuilding core healthcare payer platforms with advanced, flexible technologies that better align with contemporary and future business models, such as the shift from fee-for-service to value-based care. Key processes like provider management are being centralized to enhance efficiency. In summary, healthcare payers are now committed to a strategic digital upgrade that focuses on growth, cost-efficiency and adaptability in response to evolving industry requirements.