Health Plans

Transform the Member Experience and Drive Business Value with Purpose-Built Health Plan Solutions.

Talk to an Expert

What We’re Seeing

88%

Of global cloud decision makers at healthcare organizations are adopting cloud, which will help develop and deliver innovation

30%

Of the world’s data volume is being generated by the healthcare industry

41%

of US online adults with health insurance wish that their health insurer would do more to help them understand their health insurance benefits

87%

Of U.S. consumers have access to three or more insurers in 2023

Health plans and payors require modern, cloud-based solutions and applications capable of aggregating and organizing data, automating manual processes, and delivering actionable insights to improve experiences for both plan members and network provides while driving business value.

Ultimately, this technological investment will enable them to:

  • Deliver personalized and trusted member experiences that inspire long-term loyalty through proactive support
  • Accelerate workplace modernization and process automation, such as quote to card, using data-driven insights and automation
  • Maintain health and personal data privacy and regulatory compliance in a dynamic environment
  • Empower network providers to optimize care management and improve health outcomes for members and patients
  • Discover operational efficiencies, business opportunities, and increase transparency across departments through data integration and analytics

With Dynamics 365, we can build a single view into the heartbeat of every member, while we deliver more interoperability to providers, partners, members, and employees.

Michael Della Villa, Chief Information Officer, MVP Health Care

Read the customer story

Challenges Facing the Healthcare Payor Industry

Optimize Care Management to Improve Health Outcomes

Strengthen care coordination and improve patient safety by enabling interoperability across the health ecosystem.

Deliver Trusted Member Experiences

Curate personalized member experiences with easy and secure access to benefits and care options.

Improve Member & Provider Network Insights and Empower Data-Driven Decisions

Glean the member & provider intelligence you need with a cost-effective way to simplify and centralize your data sources.

Learn More

Accelerate Workplace Modernization

Enhance quality assurance, increase operational efficiency, and improve workforce productivity.

Protect Health Information

Keep sensitive organizational and member data private and secure.

How We Can Help

Volatile market dynamics such as rising costs, shrinking budgets, increased market competition, and new legislation and regulations are reshaping the health plan landscape as we know it. The best way to adapt to and overcome these challenges is to implement the right health plan solutions. For over a decade, Hitachi Solutions has been working with health plans and payors around the world to enhance their technological infrastructures. From cloud-based relationship management tools to automated quote-to-card capabilities, our industry IP and tight integration with Microsoft’s health plan solutions help payors stay on top of an ever-changing landscape.

Advisory

The health plan industry landscape is evolving rapidly with changes related to virtual health, value-based care, claim processing, regulations, and more. Hitachi Solutions helps make sense of the trends and guides customers through the technology and digital possibilities to envision and transform digital health and improve member and patient outcomes.

Learn More

Analytics & AI

New advancements in Artificial Intelligence (AI), data interoperability, and FHIR are allowing healthcare companies to leverage existing and new data sources in ways never thought possible, from empowering clinical and operational insights to providing the data platform for new advancements in AI to improve diagnostics, provide personalized medicine, and enhance operational efficiencies.

Learn More

Digital Transformation

Transform your healthcare applications, processes, and capabilities through adoption of digital and cloud technologies. Implement modern Electronic Health Records (EHR) for better coordinated care, enable predictive care management, and allow individuals to take charge of their health.

Learn More

Governance & Security

Confidently address your need for healthcare-specific security and compliance with planning and implementation of healthcare solutions adhering to HIPAA, HITECH, ONC Cures Act, CMS Interoperability and Patient Access Rule, and other mandates and regulations. Apply security best practices to build a foundation of security, compliance, and trust to keep sensitive health information private and secure.

Learn More

Microsoft Business Applications

Transform your business with intelligent applications that empower meaningful outcomes across the entire care journey. From personalized member experiences to improved insights and cost-savings, modern business applications accelerate the value health plans deliver to their members, network providers, and more.

Learn More

Microsoft Technology

The rapid pace of technological change in healthcare is revolutionizing member experiences and patient care while simultaneously transforming healthcare delivery. Healthcare companies need to be adaptable, agile, and prepared for these changes, facing where to begin, what to prioritize, and how to optimize technology initiatives within their budgets to support the latest digital innovations.

Learn More

Industry Solutions

Effectively manage and foster relationships across key constituents including brokers, members, network providers, and other partners. Leverage industry-tailored solutions to streamline onboarding processes, maintain a comprehensive view of historical information, performance metrics and upcoming activities to enable data-driven decision making.

Learn More

Advisory

The health plan industry landscape is evolving rapidly with changes related to virtual health, value-based care, claim processing, regulations, and more. Hitachi Solutions helps make sense of the trends and guides customers through the technology and digital possibilities to envision and transform digital health and improve member and patient outcomes.

Learn More

Analytics & AI

New advancements in Artificial Intelligence (AI), data interoperability, and FHIR are allowing healthcare companies to leverage existing and new data sources in ways never thought possible, from empowering clinical and operational insights to providing the data platform for new advancements in AI to improve diagnostics, provide personalized medicine, and enhance operational efficiencies.

Learn More

Digital Transformation

Transform your healthcare applications, processes, and capabilities through adoption of digital and cloud technologies. Implement modern Electronic Health Records (EHR) for better coordinated care, enable predictive care management, and allow individuals to take charge of their health.

Learn More

Governance & Security

Confidently address your need for healthcare-specific security and compliance with planning and implementation of healthcare solutions adhering to HIPAA, HITECH, ONC Cures Act, CMS Interoperability and Patient Access Rule, and other mandates and regulations. Apply security best practices to build a foundation of security, compliance, and trust to keep sensitive health information private and secure.

Learn More

Microsoft Business Applications

Transform your business with intelligent applications that empower meaningful outcomes across the entire care journey. From personalized member experiences to improved insights and cost-savings, modern business applications accelerate the value health plans deliver to their members, network providers, and more.

Learn More

Microsoft Technology

The rapid pace of technological change in healthcare is revolutionizing member experiences and patient care while simultaneously transforming healthcare delivery. Healthcare companies need to be adaptable, agile, and prepared for these changes, facing where to begin, what to prioritize, and how to optimize technology initiatives within their budgets to support the latest digital innovations.

Learn More

Industry Solutions

Effectively manage and foster relationships across key constituents including brokers, members, network providers, and other partners. Leverage industry-tailored solutions to streamline onboarding processes, maintain a comprehensive view of historical information, performance metrics and upcoming activities to enable data-driven decision making.

Learn More

Our Approach

What Sets Us Apart

Hitachi Solutions and Microsoft have the digital health plan solutions and proven expertise that plans and payors require to meet emerging and dynamic business needs and be more responsive, efficient, and personalized in their approach.

Our industry expertise, close relationship with Microsoft, access to global resources, and ability to deliver local support makes Hitachi Solutions unique amongst independent software vendors. Let us show you how our battle-tested methodology and health plan IP can be a vital solution for your organization to strengthen member and provider relationships, enhance operational efficiency, and accelerate modernization.

Industry Insights

We’re Here to Help

To learn more about how Hitachi Solutions can help your projects succeed, contact us today.

Contact Us