At Infosys, our Insurance, Healthcare and Life Sciences teams strive for holistic, better and safer healthcare through the technology we create. In this blog, we will discuss healthcare IT, obstacles, successes, new ideas and much more, with the aim of improving healthcare technology, and quality of life as a result.

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Why ICD-10 is the perfect opportunity to move away from legacy systems?

Be it the healthcare reform, requiring payers to use at least 80% of their premium revenues to pay claims, or the insurance exchanges driving competition to their doorsteps, the message to US health insurance industry is clear - either run your business efficiently, or go out of business.

Running the business efficiently is easier said than done, especially for payers running their business on inflexible legacy systems. There has been significant effort from some of the largest payers in the past few years to consolidate multiple platforms and migrate to agile and flexible platforms. Others need to follow suit and ICD-10 is the perfect opportunity.

At the outset, it might appear that "inflexibility of the legacy platform to adapt to ICD-10" should be the primary driver for such a migration. In other words, it might not seem like a good bargain to migrate, as long as it is not cost prohibitive to implement ICD-10 in the legacy environment. This is a very narrow and one-dimensional perspective.

Implementing ICD-10 the right way is really about transforming the business itself; it is about doing different things and doing things "very differently" than they are done today. Therefore, to get a broader sense of the opportunity, the following questions must be asked:

•Is the legacy platform flexible enough to align with such a major transformation of the business itself?
•Will the legacy platform be able to meet the organization's objectives of ICD-10 implementation?
•Will the legacy platform play any part in making the "new" business processes efficient?
•Will the current platform be able to accommodate the hundreds of new opportunities ICD-10 brings to the table?
•Will it be cost effective to align the legacy platform to the new business model?
•Will we need to migrate to a new platform in couple years post the ICD-10 implementation anyways?

Answers to these questions will provide insights that will make the decision-making comprehensive and in most cases point to the fact that "ICD-10 is indeed the perfect opportunity to migrate to cutting edge platforms".

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