An Investment in Modern Technology is an Investment in the Future

In our high-tech world, where AI can support doctors in narrowing down complex diagnoses and tech-forward infrastructure can streamline even the most archaic processes, it’s surprising that many hospital systems and payers still use legacy technology (or no technology at all!) to accomplish routine administrative tasks.

At Certify’s recent Blueprint Summit, several of our speakers discussed the impact of outdated, clunky technology in healthcare. For example:

• Provider data is compiled utilizing multiple sources, making it highly prone to error.
• Some administrative teams manually input provider data from faxed forms.
• Hospital information systems don’t have real-time data access, leaving physicians and administrators to work without pertinent information.
• Some practice management systems use paper forms instead of electronic records.

Legacy technology is costing healthcare systems and payers millions of dollars. A 2022 CAQH Index report states that health plans and providers could save up to $187 billion annually by automating administrative transactions. Sarah Ahmad, the CEO of CAQH shared that she believes health systems could save over $75 million each year simply by updating the technology responsible for provider data management. That’s just one area of healthcare administration—imagine if those savings were applied across multiple priorities. The impact could be astronomical.

Although healthcare systems, payers, practitioners, and members all benefit from the implementation of modern technology, several barriers to adoption still exist. To highlight this, we are going to explore the ROI of modern technology, discuss common barriers that healthcare systems and payers face when investing in modern technology, and share some straightforward strategies to help you overcome these barriers.

Our goal is to empower you to make informed investments in a contemporary, high-tech healthcare system that benefits all stakeholders, including members, providers, payers, and systems in order to power the strong and efficient healthcare system we will need in the coming years.

The Financial ROI of a Modern Techstack

Although there is little doubt that an investment in modern technology will pay off in the long term, the immediate costs often give payers and systems pause for concern. When every dollar saved can be invested in patient health, leaders want to ensure that their investments in technology will have an ROI.

We can assure you: They will.

To put this in perspective, we conducted some extrapolation based on the data: The estimated average per-provider spend on health technology is approximately $ 8,000 in hospital systems, with some reporting spending as high as $32,500 per physician.

At the same time, it’s estimated that the adoption of modern technology can save companies 30% in IT costs. That means that by adopting a modern tech stack, you can expect savings between $2,400 and $9,750 per year, per physician. An average hospital system with 1,000 physicians could realize financial savings between $2.4 million and $9.7 million per year, and this doesn’t take into account further savings related to efficiencies, staff turnover, and compliance.

Modern Tech Leads to Efficiencies

In addition to a financial ROI, the advent of new efficiency-boosting technology has created a means for healthcare systems and payers to streamline workflows. Advances in Agentic AI, as well as in API-based administrative tools, have created efficiencies in both the clinical and administrative sides of healthcare.

One hospital system reported that its operational efficiency increased by 35% after modernizing its tech stack, and another smaller hospital reported that implementing modern technology to perform simple, everyday administrative tasks saved them more than 1,700 hours and $3.6 million.

An investment in modern technology not only saves payers and systems money, but also allows physicians to spend more time caring for patients, and administrative teams to complete tasks in a fraction of the time. This reduces turnover and burnout, a considerable benefit as staffing shortages plague healthcare systems.

Improved Compliance

At the Blueprint Summit, Mike Kane, SVP of Provider Data Operations at UnitedHealthcare, and Jamila Sykes, VP of Provider Data Operations and Reimbursement at Highmark Health, discussed the growing regulatory demands on payers.

Systems that require manually entered data not only create hours of additional administrative work, but they also have an error rate of between 1% and 5%. This error rate, with as many as five mistakes for every 100 records, can lead to regulatory fines, member dissatisfaction, the need for re-entry of data, costing systems and payers millions of dollars.

Additionally, the 2022 No Surprises Act aims to ensure members aren’t surprised by outdated or out-of-network provider costs. As part of this bill, and many others, payers are required to provide their provider data that is both accurate and up-to-date. This is particularly challenging with outdated infrastructure and inefficient processes, leaving payers vulnerable to skyrocketing costs and regulatory fines.

The adoption of modern technology, particularly systems that facilitate streamlined data management and a single source of truth, can help healthcare payers navigate these increasing regulatory demands and ensure compliance.

Strategies for Overcoming Barriers to Technology Implementation

An investment in modern technology has a substantial financial ROI in addition to savings in efficiencies, compliance, and more. That said, there are barriers to implementation that systems and payers should be aware of.

Perhaps the most significant barrier is financial—healthcare costs are surging, making it challenging to justify additional spending. Additionally, some systems worry that adoption will add an extra administrative burden to their already overworked teams and that the return on investment won’t materialize for several years.

We discussed this with several healthcare industry leaders at Blueprint and wanted to share a few strategies that have worked for other payers and systems in overcoming these barriers.

• Invest in cloud-based API platforms that don’t require the purchase of expensive hardware or systems.
• Implement a phased rollout, starting with low-hanging fruit, such as administrative tools, and then moving on to more expensive technology.
• Adopt clear operating procedures and train your team on how to follow SOPs.
• Identify opportunities to streamline workflows, thereby lowering the administrative burden and reducing errors.
• Prioritize data integrity to minimize compliance errors, then proceed to other systems.

Replacing legacy systems with modern technology is a crucial step in reducing administrative burdens, minimizing errors, and streamlining processes. This isn’t just an upgrade to your tech stack—it’s a strategic transformation that will save you money, time, and improve outcomes both now and in the years to come. The financial payoff is compelling, but more than that, modern technology unlocks human potential, saving thousands of administrative hours and ensuring data integrity.

The ROI of a modern health tech stack is real and rapid. This one investment can help you reclaim time, slash costs, meet regulatory standards, reduce burnout, and ultimately redirect focus to what matters most: patient care.

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