At the Healthcare Interactive Conference (HCIC) last month, I got to talk to marketers who are very focused on results. They are also very focused on what will impact their marketing efforts and why. Every conversation came back to AI.

In my previous HCIC takeaway, I wrote about how AI is not a strategy—it’s a tool to solve real problems. Now I want to dig into a specific problem AI is creating for healthcare marketers: how we get found. We need to be thinking about all aspects of how AI can be used. In general, this breaks down into both impact and opportunity.

Impact: AI Search Is Transforming Healthcare Discovery

Several conference sessions alluded to this shift, but marketing experts Brittany Young and Gina Linville gave some deeper insight.

From a marketing perspective, the largest impact is one of being found. Think about how much time a typical hospital marketer puts into being found. I have had many conversations over the years about Search Engine Optimization (SEO) and the importance of having valuable content that the search engines view as unique and relevant.

AI impacts that in ways that are not at first obvious.

The New Reality of Patient Search

Think of how you typically use ChatGPT or how your search engine has evolved. AI now pulls the data and gives you a brief with information culled from multiple online sources. The good news is that the AI tool will typically reference a website it sources. The bad news is while AI typically credits source websites, patients get their answers without ever clicking through to your site.

The scale of this shift is staggering:

AI provides an overview for up to 84% of search queries when it comes to healthcare questions.

Healthcare leads nearly every sector in AI-powered search results—a trend that’s accelerating:

Strategic Response: Winning at AI Search in Healthcare

This shift demands a fundamental rethinking of content strategy. Two concepts are emerging as critical:

1) Answer Engine Optimization (AEO)

• Answer Engine Optimization (AEO) is the practice of structuring and optimizing content so that AI-powered systems, such as Google’s AI Overviews, ChatGPT, Perplexity AI, and voice assistants, can easily identify, extract, and cite it as a direct answer to user queries.

2) Generative Engine Optimization (GEO)

• Generative Engine Optimization (GEO) is a digital marketing technique designed to improve a brand’s visibility in results produced by generative artificial intelligence (GenAI) platforms. It involves adapting digital content and online presence to ensure that AI systems can accurately interpret, cite, and use the content when generating responses to user queries.

The imperative is clear: Organizations that don’t optimize for AI-powered discovery won’t just lose rankings—they’ll lose visibility entirely.

If you are not already thinking about how to orient your content to this then be aware that you will soon feel an impact.

Opportunity: Agentic AI and Productivity

On the flip side of the coin is the opportunity. While the impact above provides you with an opportunity provided you react appropriately, I want to focus on the productivity part of this. Specifically, think of what Agentic AI can do for your organization.

What Traditional Campaign Development Looks Like

Let me give you a few examples of common tasks and how long they typically take:

• Create a campaign brief: up to two weeks
• Create copy across multiple channels: 8-16 hours
• Create digital assets related to the campaign which fit your brand standards and work in each individual channel. Web site may allow for larger images. Paid search or paid social may have limited space: 40 hours
• Creation of the segment and pushing it to marketing automation tools: several hours

Now imagine specialized AI agents handling each component—not replacing human strategy and judgment, but accelerating execution while maintaining brand standards and compliance. Just getting one campaign going across multiple channels become a multi-person engagement over several weeks. While focused on that, you won’t focus on additional campaign or in honing your craft.

The AI Agent Team Your Marketing Organization Needs

The answer lies with Agentic AI. We believe that AI can cut down on the time necessary to complete these tasks and still keep humans in the loop. Here are a few examples of agents you might need in your organization:

Most importantly, this frees your marketing team to focus on what AI can’t do: strategic thinking, creative problem-solving, and understanding the nuanced needs of your community. 

The Path Forward: Integration, Not Replacement

The organizations winning in this new landscape aren’t choosing between human expertise and AI capabilities. They’re strategically integrating both.

Success requires more than technology. It needs an integrated approach:

1. Rethinking discoverability through AEO and GEO optimization
2. Deploying specialized AI agents for productivity acceleration
3. Maintaining human oversight for strategy, creativity, and judgment
4. Ensuring compliance at every step, particularly in heavily regulated healthcare
5. Measuring impact against business outcomes, not just operational metrics

Enabling Healthcare Organizations To Lead This Shift

HCIC reminded us that success in healthcare marketing isn’t about chasing technology for its own sake. As I shared in my first HCIC takeaway, AI is not a strategy—it’s a tool to solve real challenges that impact your organization’s ability to connect patients to care.

The search revolution is here. The productivity opportunity is real. The organizations that move quickly to optimize for AI-powered discovery while deploying strategic AI agents will gain a competitive advantage that compounds over time.

Start a conversation with our experts today.

A health insurance model built for yesterday won’t meet the demands of today’s consumers. Expectations for seamless, intuitive experiences are accelerating, while fragmented systems continue to drive up costs, create blind spots, and erode trust.

Addressing these challenges takes more than incremental fixes. The path forward requires breaking down silos and creating synergy across plans, while aligning technology, strategy, and teams to deliver human-centered experiences at scale. This is more than operational; it’s strategic. It’s how health insurers build resilience, move with speed and purpose, and stay ahead of evolving demands.

Reflecting on recent industry conversations, we’re proud to have sponsored LeadersIgnite and the 2025 Inter-Plan Solutions Forum. As Hari Madamalla shared:

“When insurers share insights, build solutions together, and scale what works, they can cut costs, streamline prior authorization and pricing, and deliver the experiences members expect.”– Hari Madamalla, Senior Vice President, Healthcare + Life Sciences

To dig deeper into these challenges, we spoke with healthcare leaders Hari Madamalla, senior vice president, and directors Pavan Madhira and Priyal Patel about how health insurers can create a competitive edge by leveraging digital innovation with inter-plan collaboration.

The Complexity Challenge Health Insurers Can’t Ignore

Health insurance faces strain from every angle: slow authorizations, confusing pricing, fragmented data, and widening care gaps. The reality is, manual fixes won’t solve these challenges. Plans need smarter systems that deliver clarity and speed at scale. AI and automation make it possible to turn data into insight, reduce fragmentation, and meet mandates without adding complexity.

“Healthcare has long struggled with inefficiencies and slow tech adoption—but the AI revolution is changing that. We’re at a pivotal moment, similar to the digital shift of the 1990s, where AI is poised to disrupt outdated processes and drive real transformation.” – Pavan Madhira, Director, Healthcare + Life Sciences

But healthcare organizations face unique constraints, including HIPAA, PHI, and PII regulations that limit the utility of plug-and-play AI solutions. To meet these challenges, we apply our PACE framework—Policies, Advocacy, Controls, and Enablement—to ensure AI is not only innovative but also rooted in trust. This approach ensures AI is deployed with purpose, aligned to business goals, and embedded with safeguards that protect consumers and organizations.

Still, technology alone isn’t enough though. Staying relevant means designing human-centered experiences that reduce friction and build trust. Perficient’s award-winning Access to Care research study reveals that friction in the care journey directly impacts consumer loyalty and revenue.

More than 45% of consumers aged 18–64 have used digital-first care instead of their regular provider, and 92% of them believe the quality is equal to—or better.

That’s a signal healthcare leaders can’t afford to ignore. It tells us when experiences fall short, consumers go elsewhere, and they won’t always come back.

For health insurers, that shift creates issues. When members seek care outside your ecosystem, you risk losing visibility into care journeys, creating gaps in data and blind spots in member health management. The result? Higher costs, duplicative services, and missed opportunities for proactive coordination. Fragmented care journeys also undermine efforts to deliver a true 360-degree view of the member. The solution lies in intuitive digital transformation that turns complexity into clarity.

Explore More: Empathy, Resilience, Innovation, and Speed: The Blueprint for Intelligent Healthcare Transformation

Where Inter-Plan Collaboration Creates Real Momentum

When health plans work together, the payoff is significant. Collaboration moves the industry from silos to synergy, enabling human-centered experiences across networks that keep members engaged and revenue intact.

Building resilience is key to that success. Leaders need systems that anticipate member needs and remove barriers before they impact access to care. That means reducing friction in scheduling and follow-up, enabling seamless coordination across networks, and delivering digital experiences that feel as simple and intuitive as consumer platforms like Amazon or Uber. Resilience also means preparing for the unexpected and being able to pivot quickly.

When plans take this approach, the impact is clear:

• Higher Quality Scores and Star Ratings: Shared strategies for closing gaps and improving provider data can help lift HEDIS scores and Star Ratings, unlocking higher reimbursement and bonus pools.
• Faster Prior Authorizations: Coordinated rules and automation help reduce delays and meet new regulatory requirements like CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F).
• True Price Transparency: Consistent, easy-to-understand cost and quality information across plans helps consumers make confident choices and stay in-network.
• Stronger Member Loyalty: Unified digital experiences across plans help improve satisfaction and engagement.
• Lower Administrative Overhead: Cleaner member data means fewer errors, less duplication, and lower compliance risk.

“When plans work together, they can better serve their vulnerable populations, reduce disparities, and really drive to value based care. It’s about building trust, sharing responsibility, and innovating with empathy.” – Priyal Patel, Director, Healthcare + Life Sciences

Resilience and speed go hand in hand though. Our experts help health insurers deliver both by:

• Designing for agility with composable architectures, MVP+ delivery models, and intelligent automation that accelerates time-to-value while maintaining regulatory integrity.
• Aligning digital transformation with value-based care goals, enabling organizations to shift from volume to value through strategic investments that integrate cloud platforms, interoperable systems, and advanced analytics.
• Operationalizing AI responsibly to support equitable, secure, compliant, and scalable AI adoption.

This approach supports the Quintuple Aim: better outcomes, lower costs, improved experiences, clinician well-being, and health equity. It also ensures that innovation is not just fast, but focused, ethical, and sustainable.

You May Also Enjoy: Access to Care is Evolving: What Consumer Insights and Behavior Models Reveal

Accelerating Impact With Digital Innovation and Inter-Plan Collaboration

Beyond these outcomes, collaboration paired with digital innovation unlocks even greater opportunities to build a smarter, more connected future of healthcare. It starts with aligning consumer expectations, digital infrastructure, and data governance to strategic business goals.

Here’s how plans can accelerate impact:

• Real-Time Data Sharing and Interoperability: Shared learning ensures insights aren’t siloed. By pooling knowledge across plans, leaders can identify patterns, anticipate emerging trends, and act faster on what works. Real-time interoperability, like FHIR-enabled solutions, gives plans the visibility needed for accurate risk adjustment and timely quality reporting. AI enhances this by predicting gaps and surface actionable insights, helping plans act faster and reduce costs.
• Managing Coding Intensity in the AI Era: As provider AI tools capture more diagnoses, insurers can see risk scores and costs rise, creating audit risk and financial exposure. This challenge requires proactive oversight. Collaboration helps by establishing shared standards and applying predictive analytics to detect anomalies early, turning a potential cost driver into a managed risk.
• Prior Authorization Modernization: Prior authorization delays drive up costs and erode member experience. Aligning on streamlined processes and leveraging intelligent automation can help meet mandates like CMS-0057-F, while predicting approval likelihood, flagging exceptions early, and accelerating turnaround times.
• Joint Innovation Pilots: Co-development of innovation means plans can shape technology together. This approach balances unique needs with shared goals, creating solutions that cut costs, accelerate time to value, and ensure compliance stays front and center.
• Engaging Member Experience Frameworks: Scaling proven approaches across plans amplifies impact. When plans collaborate on digital experience standards and successful capabilities are replicated, members enjoy seamless interactions across networks. Building these experiences on solid foundations with purpose-driven AI is key to delivering stronger engagement and loyalty at scale.
• Shared Governance and Policy Alignment: Joint governance establishes accountability, aligns incentives for value-based care, and reduces compliance risk while protecting revenue.

Success in Action: Empowering Healthcare Consumers and Their Care Ecosystems With Interoperable Data

Make Inter-Plan Collaboration Your Strategic Advantage

Ready to move from insight to impact? Our healthcare expertise equips leaders to modernize, personalize, and scale care. We drive resilient, AI-powered transformation to shape the experiences and engagement of healthcare consumers, streamline operations, and improve the cost, quality, and equity of care.

• Business Transformation: Activate strategy for transformative outcomes and health experiences.
• Modernization: Maximize technology to drive health innovation, efficiency, and interoperability.
• Data + Analytics: Power enterprise agility and accelerate healthcare insights.
• Consumer Experience: Connect, ease, and elevate impactful health journeys.

We have been trusted by the 10 largest health systems and the 10 largest health insurers in the U.S., and Modern Healthcare consistently ranks us as one of the largest healthcare consulting firms.

The headlines are troubling but predictable. The Trump administration will launch a program next year to find out how much money an artificial intelligence algorithm could save the federal government by denying care to Medicare patients. Meanwhile, a survey of physicians published by the American Medical Association in February found that 61% think AI is “increasing prior authorization denials, exacerbating avoidable patient harms and escalating unnecessary waste now and into the future.”

We’re witnessing the healthcare industry’s narrow vision of AI in action: algorithms designed to say “no” faster and more efficiently than ever before. But what if we’re missing the bigger opportunity?

The Current AI Problem: Built to Deny, Not to Help

The recent expansion of AI-powered prior authorization reveals a fundamental flaw in how we’re approaching healthcare technology. “The more expensive it is, the more likely it is to be denied,” said Jennifer Oliva, a professor at the Maurer School of Law at Indiana University-Bloomington, whose work focuses on AI regulation and health coverage.

This approach creates a vicious cycle: patients don’t understand their benefits, seek inappropriate or unnecessary care, trigger costly prior authorization processes, face denials, appeal those denials, and ultimately either give up or create even more administrative burden for everyone involved.

The human cost is real. Nearly three-quarters of respondents thought prior authorization was a “major” problem in a July poll published by KFF, and we’ve seen how public displeasure with insurance denials dominated the news in December, when the shooting death of UnitedHealthcare’s CEO led many to anoint his alleged killer as a folk hero.

A Better Vision: The AI Concierge Approach

What if instead of using AI to deny care more efficiently, we used it to help patients access the right care more effectively? This is where the AI Concierge concept transforms the entire equation.

An AI Concierge doesn’t wait for a claim to be submitted to make a decision. Instead, it proactively:

• Educates patients about their benefits before they need care
• Guides them to appropriate providers within their network
• Explains coverage limitations in plain language before appointments
• Suggests preventive alternatives that could avoid more expensive interventions
• Streamlines pre-authorization by ensuring patients have the right documentation upfront

The Quantified Business Case

The financial argument for AI Concierge services is compelling:

Star Ratings Revenue Impact: A half-star increase in Medicare Star Ratings is valued at approximately $500 per member. For a 75,000-member plan, that translates to $37.5 million in additional funding. An AI Concierge directly improves patient satisfaction scores that drive these ratings.

Operational Efficiency Gains: Healthcare providers implementing AI-powered patient engagement systems report 15-20% boosts in clinic revenue and 10-20% reductions in overall operational costs. Clinics using AI tools see 15-25% increases in patient retention rates.

Cost Avoidance Through Prevention: Utilizing AI to help patients access appropriate care could save up to 50% on treatment costs while improving health outcomes by up to 40%. This happens by preventing more expensive interventions through proper preventive care utilization.

The HEDIS Connection

HEDIS measures provide the perfect framework for demonstrating AI Concierge value. With 235 million people enrolled in plans that report HEDIS results, improving these scores directly impacts revenue through bonus payments and competitive positioning.

An AI Concierge naturally improves HEDIS performance in:

• Preventive Care Measures: Proactive guidance increases screening and immunization rates
• Care Gap Closure: Identifies and addresses gaps before they become expensive problems
• Patient Engagement: Improves medication adherence and chronic disease management

Beyond the Pilot Programs

While government initiatives like the WISeR pilot program focus on “Wasteful and Inappropriate Service Reduction” through AI-powered denials, forward-thinking healthcare organizations have an opportunity to differentiate themselves with AI-powered patient empowerment.

The math is simple: preventing a $50,000 hospitalization through proactive care coordination delivers better ROI than efficiently denying the claim after it’s submitted.

AI Healthcare Concierge Implementation Strategy

For healthcare leaders considering AI Concierge implementation:

• Phase 1: Deploy AI-powered benefit explanation tools that reduce call center volume and improve patient understanding
• Phase 2: Integrate predictive analytics to identify patients at risk for expensive interventions and guide them to preventive alternatives
• Phase 3: Expand to comprehensive care navigation that optimizes both patient outcomes and organizational performance

The Competitive Advantage

While competitors invest in AI to process denials faster, organizations implementing AI Concierge services are investing in:

• Member satisfaction and retention (15-25% improvement rates)
• Star rating improvements ($500 per member value per half-star)
• Operational cost reduction (10-20% typical savings)
• Revenue protection through better member experience

Conclusion: Choose Your AI Future

The current trajectory of AI in healthcare—focused on denial optimization—represents a massive missed opportunity. As one physician noted about the Medicare pilot: “I will always, always err on the side that doctors know what’s best for their patients.”

AI Healthcare Concierge services align with this principle by empowering both patients and providers with better information, earlier intervention, and more effective care coordination. The technology exists. The business case is proven. The patient need is urgent.

The question isn’t whether AI will transform healthcare—it’s whether we’ll use it to build walls or bridges between patients and the care they need.

The choice is ours. Let’s choose wisely.

Empathy, Resilience, Innovation, and Speed: The Blueprint for Intelligent Healthcare Transformation

Forrester’s recent report, Becoming An Intelligent Healthcare Organization Is An Attainable Goal, Not A Lost Cause, confirms what healthcare executives already know: transformation is no longer optional.

Perficient is proud to be quoted in this research, which outlines a pragmatic framework for becoming an intelligent healthcare organization (IHO)—one that scales innovation, strengthens clinical and operational performance, and delivers measurable impact across the enterprise and the populations it serves.

Why Intelligent Healthcare Is No Longer Optional

Healthcare leaders are under pressure to deliver better outcomes, reduce costs, and modernize operations, all while navigating fragmented systems and siloed departments. The journey to transformation requires more than technology; it demands strategic clarity, operational alignment, and a commitment to continuous improvement.

Forrester reports, “Among business and technology professionals at large US healthcare firms, only 63% agree that their IT organization can readily reallocate people and technologies to serve the newest business priority; 65% say they have enterprise architecture that can quickly and efficiently support major changes in business strategy and execution.”

Despite widespread investment in digital tools, many healthcare organizations struggle to translate those investments into enterprise-wide impact. Misaligned priorities, inconsistent progress across departments, and legacy systems often create bottlenecks that stall innovation and dilute momentum.

Breaking Through Transformation Barriers

These challenges aren’t just technical or organizational. They’re strategic. Enterprise leaders can no longer sit on the sidelines and play the “wait and see” game. They must shift from reactive IT management to proactive digital orchestration, where technology, talent, and transformation are aligned to business outcomes.

Business transformation is not a fleeting trend. It’s an essential strategy for healthcare organizations that want to remain competitive as the marketplace evolves.

Forrester’s report identifies four hallmarks of intelligent healthcare organizations, emphasizing that transformation is not a destination but a continuous practice.

Four Hallmarks of An Intelligent Healthcare Organization (IHO)

To overcome transformation barriers, healthcare organizations must align consumer expectations, digital infrastructure, clinical workflows, and data governance with strategic business goals.

1. Empathy At Scale: Human-Centered, Trust-Enhancing Experiences

A defining trait of intelligent healthcare organizations is a commitment to human-centered experiences.

• Driven By: Continuous understanding of consumer needs
• Supported By: Strategic technology investments that enable timely, personalized interventions and touchpoints

As Forrester notes, “The most intelligent organizations excel at empathetic, swift, and resilient innovation to continuously deliver new value for customers and stay ahead of the competition.”

Empathy is a performance driver. Organizations that prioritize human-centered care see higher engagement, better adherence, and stronger loyalty.

Our experts help clients reimagine care journeys using journey sciences, predictive analytics, integrated CRM and CDP platforms, and cloud-native architectures that support scalable personalization. But personalization without protection is a risk. That’s why empathy must extend beyond experience design to include ethical, secure, and responsible AI adoption.

Healthcare organizations face unique constraints, including HIPAA, PHI, and PII regulations that limit the utility of plug-and-play AI solutions. To meet these challenges, we apply our PACE framework—Policies, Advocacy, Controls, and Enablement—to ensure AI is not only innovative but also rooted in trust.

• Policies establish clear boundaries for acceptable AI usage, tailored to healthcare’s regulatory landscape.
• Advocacy builds cross-functional understanding and adoption through education and collaboration.
• Controls implement oversight, auditing, and risk mitigation to protect patient data and ensure model integrity.
• Enablement equips teams with the tools and environments needed to innovate confidently and securely.

This approach ensures AI is deployed with purpose, aligned to business goals, and embedded with safeguards that protect consumers and care teams alike. It also supports the creation of reusable architectures that blend scalable services with real-time monitoring, which is critical for delivering fast, reliable, and compliant AI applications.

Responsible AI isn’t a checkbox. It’s a continuous practice. And in healthcare, it’s the difference between innovation that inspires trust and innovation that invites scrutiny.

2. Designing for Disruption: Resilience as a Competitive Advantage

Patient-led experiences must be grounded in a clear-eyed understanding that market disruption isn’t simply looming. It’s already here. To thrive, healthcare leaders must architect systems that flex under pressure and evolve with purpose. Resilience is more than operational; it’s also behavioral, cultural, and strategic.

Perficient’s Access to Care research reveals that friction in the care journey directly impacts health outcomes, loyalty, and revenue:

• More than 50% of consumers who experienced scheduling friction took their care elsewhere, resulting in lost revenue, trust, and care continuity
• 33% of respondents acted as caregivers, yet this persona is often overlooked in digital strategies
• Nearly 1 in 4 respondents who experienced difficulty scheduling an appointment stated that the friction led to delayed care, and they believed their health declined as a result
• More than 45% of consumers aged 18–64 have used digital-first care instead of their regular provider, and 92% of them believe the quality is equal or better

This sentiment should be a wakeup call for leaders. It clearly signals that consumers expect healthcare to meet both foundational needs (cost, access) and lifestyle standards (convenience, personalization, digital ease). When systems fail to deliver, patients disengage. And when caregivers—who often manage care for entire households—encounter barriers, the ripple effect is exponential.

To build resilience that drives retention and revenue, leaders must design systems that anticipate needs and remove barriers before they impact care. Resilient operations must therefore be designed to:

• Reduce friction across the care journey, especially in scheduling and follow-up
• Support caregivers with multi-profile tools, shared access, and streamlined coordination
• Enable digital-first engagement that mirrors the ease of consumer platforms like Amazon and Uber

Consumers are blending survival needs with lifestyle demands. Intelligent healthcare organizations address both simultaneously.

Resilience also means preparing for the unexpected. Whether it’s regulatory shifts, staffing shortages, or competitive disruption, IHOs must be able to pivot quickly. That requires leaders to reimagine patient (and member) access as a strategic lever and prioritize digital transformation that eases the path to care.

3. Unified Innovation: Aligning Strategy, Tech, and Teams

Innovation without enterprise alignment is just noise—activity without impact. When digital initiatives are disconnected from business strategy, consumer needs, or operational realities, they create confusion, dilute resources, and fail to deliver meaningful outcomes. Fragmented innovation may look impressive in isolation, but without coordination, it lacks the momentum to drive true transformation.

To deliver real results, healthcare leaders must connect strategy, execution, and change readiness. In Forrester’s report, a quote from an interview with Priyal Patel emphasizes the importance of a shared strategic vision:

“Today’s decisions should be guided by long-term thinking, envisioning your organization’s business needs five to 10 years into the future.” — Priyal Patel, Director, Perficient

Our approach begins with strategic clarity. Using our Envision Framework, we help healthcare organizations rapidly identify opportunities, define a consumer-centric vision, and develop a prioritized roadmap that aligns with business goals and stakeholder expectations. This framework blends real-world insights with pragmatic planning, ensuring that innovation is both visionary and executable.

We also recognize that transformation is not just technical—it’s human. Organizational change management (OCM) ensures that teams are ready, willing, and able to adopt new ways of working. Through structured engagement, training, and sustainment, we help clients navigate the behavioral shifts required to scale innovation across departments and disciplines.

This strategic rigor is especially critical in healthcare, where innovation must be resilient, compliant, and deeply empathetic. As highlighted in our 2025 Digital Healthcare Trends report, successful organizations are those that align innovation with measurable business outcomes, ethical AI adoption, and consumer trust.

Perficient’s strategy and transformation services connect vision to execution, ensuring that innovation is sustainable. We partner with healthcare leaders to identify friction points and quick wins, build a culture of continuous improvement, and empower change agents across the enterprise.

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4. Speed With Purpose and Strategic Precision

The ability to pivot, scale, and deliver quickly is becoming a defining trait of tomorrow’s healthcare leaders. The way forward requires a comprehensive digital strategy that builds the capabilities, agility, and alignment to stay ahead of evolving demands and deliver meaningful impact.

IHOs act quickly without sacrificing quality. But speed alone isn’t enough. Perficient’s strategic position emphasizes speed with purpose—where every acceleration is grounded in business value, ethical AI adoption, and measurable health outcomes.

Our experts help healthcare organizations move fast by:

• Designing for agility with composable architectures, MVP+ delivery models, and intelligent automation that compliantly accelerates time-to-value while maintaining clinical integrity
• Aligning digital transformation with value-based care goals, enabling organizations to shift from volume to value through strategic investments that integrate cloud platforms, interoperable systems, and advanced analytics
• Operationalizing AI responsibly to support equitable, secure, compliant, and scalable AI adoption

This approach supports the Quintuple Aim: better outcomes, lower costs, improved experiences, clinician well-being, and health equity. It also ensures that innovation is not just fast. It’s focused, ethical, and sustainable.

Speed with purpose means:

• Rapid prototyping that validates ideas before scaling
• Real-time data visibility to inform decisions and interventions
• Cross-functional collaboration that breaks down silos and accelerates execution
• Outcome-driven KPIs that measure impact, not just activity

Healthcare leaders don’t need more tools. They need a strategy that connects business imperatives, consumer demands, and an empowered workforce to drive transformation forward. Perficient equips organizations to move with confidence, clarity, and control.

Collaborating to Build Intelligent Healthcare Organizations

We believe our inclusion in Forrester’s report underscores our role as a trusted advisor in intelligent healthcare transformation. From insight to impact, our healthcare expertise equips leaders to modernize, personalize, and scale care. We drive resilient, AI-powered transformation to shape the experiences and engagement of healthcare consumers, streamline operations, and improve the cost, quality, and equity of care.

We have been trusted by the 10 largest health systems and the 10 largest health insurers in the U.S., and Modern Healthcare consistently ranks us as one of the largest healthcare consulting firms.

Our strategic partnerships with industry-leading technology innovators—including AWS, Microsoft, Salesforce, Adobe, and more—accelerate healthcare organizations’ ability to modernize infrastructure, integrate data, and deliver intelligent experiences. Together, we shatter boundaries so you have the AI-native solutions you need to boldly advance business.

Ready to advance your journey as an intelligent healthcare organization?

We’re here to help you move beyond disconnected systems and toward a unified, data-driven future—one that delivers better experiences for patients, caregivers, and communities. Let’s connect and explore how you can lead with empathy, intelligence, and impact.

The pressure is on for healthcare organizations to deliver more—more value, more equity, more impact. That’s where a well-known approach is stepping back into the spotlight.

If you’ve been around healthcare conversations lately, you’ve probably heard the resurgence of term value-based care. And there’s a good reason for that. It’s not just a buzzword—it’s reshaping how we think about health, wellness, and the entire care experience.

What Is Value-Based Care, Really?

At its core, value-based care is a shift away from the old-school fee-for-service model, where providers got paid for every test, procedure, or visit, regardless of whether it actually helped the patient. Instead, value-based care rewards providers for delivering high-quality, efficient care that leads to better health outcomes.

It’s not about how much care is delivered, it’s about how effective that care is.

This shift matters because it places patients at the center of everything. It’s about making sure people get the right care, at the right time, in the right setting. That means fewer unnecessary tests, fewer duplicate procedures, and less of the fragmentation that’s plagued the system for decades.

The results? Better experiences for patients. Lower costs. Healthier communities.

Explore More: Access to Care Is Evolving: What Consumer Insights and Behavior Models Reveal

Benefits and Barriers of Value-Based Care in Healthcare Transformation

There’s a lot to be excited about, and for good reason! When we focus on prevention, chronic disease management, and whole-person wellness, we can avoid costly hospital stays and emergency room visits. That’s not just good for the healthcare system, it’s good for people, families, and communities. It moves us closer to the holy grail in healthcare: the quintuple aim. Achieving it means delivering better outcomes, elevating experiences for both patients and clinicians, reducing costs, and advancing health equity.

The challenge? Turning value-based care into a scalable, sustainable reality isn’t easy.

Despite more than a decade of pilots, programs, and well-intentioned reforms, only a small number of healthcare organizations have been able to scale their value-based care models effectively. Why? Because many still struggle with some pretty big roadblocks—like outdated technology, disconnected systems, siloed data, and limited ability to manage risk or coordinate care.

That’s where digital transformation comes in.

To make value-based care real and sustainable, healthcare organizations are rethinking their infrastructure from the ground up. They’re adopting cloud-based platforms and interoperable IT systems that allow for seamless data exchange across providers, payers, and patients. They’re tapping into advanced analytics, intelligent automation, and AI to identify at-risk patients, personalize care, and make smarter decisions faster.

As organizations work to enable VBC through digital transformation, it’s critical to really understand what the current research says. Our recent study, Access to Care: The Digital Imperative for Healthcare Leaders, backs up these trends, showing that digital convenience is no longer a differentiator—it’s a baseline expectation.

Findings show that nearly half of consumers have opted for digital-first care instead of visiting their regular physician or provider.

This shift highlights how important it is to offer simple and intuitive self-service digital tools that help people get what they need—fast. When it’s easy to find and access care, people are more likely to trust you, stick with you, and come back when they need you again.

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Redesigning Care Models for a Consumer-Centric, Digitally Enabled Future

Care models are also evolving. Instead of reacting to illness, we’re seeing a stronger focus on prevention, early intervention, and proactive outreach. Consumer-centric tools like mobile apps, patient portals, and personalized health reminders are becoming the norm, not the exception. It’s all part of a broader movement to meet people where they are and give them more control over their health journey.

But here’s an important reminder: none of these efforts work in a vacuum.

Value-based care isn’t just a technology upgrade or a process tweak. It’s a cultural shift.

Success requires aligning people, processes, data, and technology in a way that’s intentional and strategic. It’s about creating an integrated system that’s designed to improve outcomes and then making those improvements stick.

So, while the road to value-based care may be long and winding, the destination is worth it. It’s not just a different way of delivering care—it’s a smarter, more sustainable one.

Success In Action: Empowering Healthcare Consumers and Their Care Ecosystems With Interoperable Data

Reimagine Healthcare Transformation With Confidence

If you’re exploring how to modernize your digital front door, consider starting with a strategic assessment. Align your goals, audit your content, and evaluate your tech stack. The path to better outcomes starts with a smarter, simpler way to help patients find care.

We combine strategy, industry best practices, and technology expertise to deliver award-winning results for leading healthcare organizations.

• Business Transformation: Activate strategy for transformative outcomes and health experiences.
• Modernization: Maximize technology to drive health innovation, efficiency, and interoperability.
• Data + Analytics: Power enterprise agility and accelerate healthcare insights.
• Consumer Experience: Connect, ease, and elevate impactful health journeys.

Our approach to designing and implementing AI and machine learning (ML) solutions promotes secure and responsible adoption and ensures demonstrated and sustainable business value.

Discover why we have been trusted by the 10 largest health systems and the 10 largest health insurers in the U.S. Explore our healthcare expertise and contact us to learn more.

Healthcare organizations (HCOs) face mounting pressure to boost operational efficiency, improve health and wellness, and enhance experiences. To drive these outcomes, leaders are aligning enterprise and business goals with digital investments that intelligently automate processes and optimize the health journey. 

Clinical intelligence plays a pivotal role in this transformation. It unlocks advanced data-driven insights that enable intelligent healthcare organizations to drive health innovation and elevate impactful health experiences. This approach aligns with the healthcare industry’s quintuple aim to enhance health outcomes, reduce costs, improve patient/member experiences, advance health equity, and improve the work life of healthcare teams. 

Intelligent Healthcare Organizations: Driven By Clinical Intelligence  

Our industry experts were recently interviewed by Forrester for their April 2025 report, Clinical Intelligence Will Power The Intelligent Healthcare Organization, which explores ways healthcare and business leaders can transform workflows to propel the enterprise toward next-gen operations and experiences. 

We believe the fact that we were interviewed for this report highlights our commitment to optimize technology, interoperability, and digital experiences in ways that build consumer trust, drive innovation, and support more-personalized care.  

We combine strategy, industry best practices, and technology expertise to deliver award-winning results for leading health plans and providers: 

• Business Transformation: Activate strategy for transformative outcomes and health experiences. 
• Modernization: Maximize technology to drive health innovation, efficiency, and interoperability. 
• Data Analytics: Power enterprise agility and accelerate healthcare insights. 
• Consumer Experience: Connect, ease, and elevate impactful health journeys. 

Understand and Deliver On Consumer Needs and Expectations 

Every individual brings with them an ever-changing set of needs, preferences, and health conditions. Now more than ever, consumers are flat out demanding a more tailored approach to their health care. This means it is imperative to know your audience. If you do not approach people as individuals with unique, personal needs, you risk losing them to another organization that does.  

Becoming an intelligent healthcare organization (IHO) takes more than just a technology investment; it is a complete restructuring of the enterprise to infuse and securely utilize clinical intelligence in every area and interaction.

In its report, Forrester defines an IHO as, “A healthcare organization that perpetually captures, transforms, and delivers data at scale and creates and seamlessly disseminates clinical intelligence, maximizing clinical workflows and operations and the experience of employees and customers. IHOs operate in one connected system that empowers engagement among all stakeholders.”

Ultimately, consumers – as a patient receiving care, a member engaging in their plan’s coverage, or a caregiver supporting this process – want to make and support informed health care decisions that cost-effectively drive better health outcomes. IHOs focus on delivering high-quality, personalized insights and support to the business, care teams, and consumers when it matters most and in ways that are accessible and actionable.

Orchestrate Better Health Access 

Digital-first care stands at the forefront of transformation, providing more options than ever before as individuals search for and choose care. When digital experiences are orchestrated with consumers’ expectations and options in mind, care solutions like telehealth services, find-care experiences, and mobile health apps can help HCOs deliver the right care at the right time, through the right channel, and with guidance that eases complex decisions, supports proactive health, and activates conversions. 

The shift toward digital-first care solutions means it is even more crucial for HCOs to understand real-time consumer expectations to help shape business priorities and form empathetic, personalized experiences that build trust and loyalty. 

In its report, Forrester states, “And as consumer trust has taken a hit over the past three years, it is encouraging that 72% of healthcare business and technology professionals expect their organization to increase its investment in customer management technologies.”  

Clinical intelligence, leveraged well, can transform the ways that consumers interact and engage across the healthcare ecosystem. IHOs see clinical intelligence as a way to innovate beyond mandated goals to add business value, meet consumers’ evolving expectations, and deliver equitable care and services.  

Interoperability plays a crucial role in this process, as it enables more seamless, integrated experiences across all digital platforms and systems. This interconnectedness ensures that consumers receive consistent, coordinated care, regardless of where they are seeking treatment and are supported by informed business and clinical teams. 

Mandates such as Health Level 7 (HL7) standards, Fast Healthcare Interoperability Resources (FHIR), and Centers for Medicare & Medicaid Services (CMS) Interoperability and Patient Access Final Rule are creating a more connected and data-driven healthcare ecosystem. Additionally, CMS price transparency regulations are empowering consumers to become more informed, active, and engaged patients. Price transparency and cost estimator tools have the potential to give organizations a competitive edge and drive brand loyalty by providing a transparent, proactive, personalized, and timely experience. 

The most successful organizations will build a proper foundation that scales and supports successive mandates. Composable architecture offers a powerful, flexible approach that balances “best in breed,” fit-for-purpose solutions while bypassing unneeded, costly features or services. It’s vital to build trust in data and with consumers, paving the way for ubiquitous, fact-based decision making that supports health and enables relationships across the care continuum. 

Success In Action: Empowering Healthcare Consumers and Their Care Ecosystems With Interoperable Data

Enable Caregivers and Care Teams 

As the population ages, caregivers play an increasingly important role in the healthcare journey, and their experience is distinct. They may continually move in and out of the caregiver role. It’s essential to understand and engage these vital partners, providing them with important tools and resources to support quality care.  

Clinical intelligence can provide HCOs with advanced insights into the needs of caregivers and care teams, helping clinical, operational, IT, digital, and marketing leaders design systems that support the health and efficacy of these important care providers.  

Integrated telehealth and remote monitoring have become essential to managing chronic conditions and an aging population. Intuitive, integrated digital tools and personalized messaging can help mitigate potential health barriers by proactively addressing concerns around transportation, costs, medication adherence, appointment scheduling, and more.  

A well-planned, well-executed strategy ideally supports access to care for all, creating a healthier and more-welcoming environment for team members to build trust, elevate consumer satisfaction, and drive higher-quality care.  

Success In Action: A Digital Approach to Addressing Health Equity 

Improve Operational Efficiencies for Care Teams 

HCO leaders are investing in advanced technologies and automations to modernize operations, streamline experiences, and unlock reliable insights.  

Clinical intelligence paired with intelligent automations can accelerate patient and member care for clinical and customer care teams, helping to alleviate stress on a workforce burdened with high rates of burnout.  

In its report, Forrester shares, “In Forrester’s Priorities Survey, 2024, 65% or more of healthcare business and technology professionals said that they expect their organization to significantly increase its investments in business insights and analytics, data and information management, AI, and business automation and robotics in the next 12 months.”  

It’s clear the U.S. healthcare industry stands on the cusp of a transformative era powered by advanced analytics and holistic business transformation. AI-driven automations can reduce administrative costs, while AI-enabled treatment plans offer hyper-personalized precision medicine. As technology continues to shape healthcare experiences, Felix Bradbury, Perficient senior solutions architect, shares his thoughts on the topic: 

“Trust is crucial in healthcare. Understanding how to make AI algorithms interpretable and ensuring they can provide transparent explanations of their decisions will be key to fostering trust among clinicians and patients.” 

AI can be a powerful enabler of business priorities. To power and scale effective use cases, HCOs are investing in core building blocks: a modern and secure infrastructure, well-governed data, and team training and enablement. A well-formed strategy that aligns key business needs with people, technology, and processes can turn data into a powerful tool that accelerates operational efficiency and business success, positioning you as an intelligent healthcare organization.  

Success In Action: Engaging Diverse Audiences As They Navigate Cancer Care 

Healthcare Leaders Turn To Us

Discover why we have been trusted by the 10 largest health systems and the 10 largest health insurers in the U.S. Explore our healthcare expertise and contact us to learn more. 

As private health insurers weather industry headwinds, strategic transformation priorities remain firmly centered on operations and patient-centric experiences that accelerate efficiencies. Outcomes-driven leaders recognize the value of aligning key business needs with people, technology, and processes. 

Leading Digital Transformation for U.S. Payers 

We are proud to announce the recent recognition of Perficient’s digital services for healthcare payers by an industry-leading advisory firm. This highlights the value that our expert, global teams bring to the largest U.S. health insurers as industry leaders work to improve operations, efficiency, and effectiveness.  

Now more than ever, insurers can accelerate a shift from traditional cost management to proactive health enablement. The most effective payers are integrating technologies to modernize operations, streamline experiences, and not only unlock reliable data, but elevate insights and experiences with AI and advanced, integrated analytics. AI can be harnessed to offer hyper-personalized benefit plans, predictive risk analytics, and real-time insights that not only manage costs but also enhance member experience and engagement. 

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We believe our inclusion in a leading study of digital health services showcases our dedication to easing consumer journeys, ensuring integrated data is reliable and secure, and modernizing the enterprise so it can accelerate progress toward key business priorities. We are committed to helping healthcare leaders stay competitive with our award-winning, tailored solutions.  

“This acknowledgment underscores our commitment to helping healthcare leaders optimize workflows, uncover insights, innovate care experiences, and strengthen consumer trust.”– Brent Teiken, General Manager, Healthcare + Life Sciences

Our healthcare experts guide and drive a shared understanding with clients. This insight is especially vital as leaders seek solutions to highly complex business challenges that rely on protected data and span a complex healthcare ecosystem. Our technology experts further ensure that solutions are not only implemented correctly but can scale as consumer expectations and business needs evolve.  

Success In Action: Enabling Better Insight Into Key Patient Data Using GenAI 

Elevate Health and Business Outcomes With Our Expertise 

We help health insurers navigate intense technological and regulatory requirements while controlling costs and improving the user experience to support and delight members. 

• Business Transformation: Transform strategy into action: reduce costs, increase quality, and improve member experiences. 
• Modernization: Maximize technology to drive innovative, digital-first care solutions in automation, AI, and cloud. 
• Data + Analytics: Provide governed, accessible, and trusted data to drive insight and engagement for members, providers, and groups. 
• Consumer Experience: Create personalized, value added, and measurable experiences across multiple channels for all constituents. 

Explore our healthcare expertise and contact us to discover why we have been trusted by the 10 largest U.S. health insurers, including 25 BCBS-affiliated insurers, and are consistently recognized by Modern Healthcare as one of the largest healthcare consulting firms. 

Our experts are closely monitoring eight healthcare trends that are shaping industry leaders’ strategies in 2025.

And this year is especially interesting, as 2024’s U.S. election results could significantly shift healthcare policy and impact healthcare access, affordability, regulation, and innovation.

As such, forward-looking healthcare organizations (HCOs) that are on-track to differentiate their brand in the modern marketplace demonstrate some key characteristics:

• Pragmatically progressive strategies
• Strong partnerships to see those strategies through

Let’s dive into the eight healthcare trends and pragmatic innovations that our experts are helping HCOs navigate in 2025.

Healthcare Trend #1: AI Disruption and Enablement

Healthcare has seen a surge of interest in AI, with the market set to soar to $187.95 billion by 2030. But the industry faces unique challenges that other sectors don’t encounter. Strict regulations around HIPAA, PHI, and PII create significant barriers, making it difficult to adopt off-the-shelf AI solutions from fields like commerce or digital experience. These regulations demand that healthcare AI be specifically tailored to ensure data privacy, security, and compliance, limiting the utility of plug-and-play approaches seen in other industries.

Recommended Approach: AI should not be viewed as a standalone strategy but rather as a powerful enabler of broader business objectives. A well-formed strategy aligns key business priorities with organizational capabilities – people, technology, and processes – to create a cohesive framework. AI’s transformative potential can then be harnessed to address high-impact use cases for HCOs that are defined by clear KPIs and measurable outcomes. However, this potential can only be fully realized if AI is implemented with careful consideration of ethical, security and privacy, and oversight issues. This approach ensures that AI drives tangible value, tailored to the unique needs and strengths of the organization.

Success In Action: Accelerating CSR Support of Benefits Questions Using GenAI

Healthcare Trend #2: Cost Management Without Sacrificing Agility

HCOs continue to face substantial challenges in maintaining margins. While there are many macro and operational factors at play, cost management will play a key part in C-suite planning for the foreseeable future. Against this background, leaders are still under intense competitive pressure to improve many aspects of the digital experience. This tension is driving renewed interest in automation, including AI, and an emphasis on MVP+ and Agile delivery of everything from data modernization to websites and search.

Recommended Approach: Strategic cohesion is vital to ensure initiatives are supported by extremely clear goals and KPIs, and ultimately deliver business value and better health outcomes. A rigorous yet practical business transformation mindset has therefore never been more important. Leaders must prioritize technology investments that balance shorter-term wins and longer-range viability. Cost containment will require compromises. Thus, organizational alignment and change management become even more vital as teams competing for technology development dollars evolve their focus from departmental goals to enterprise sustainability.

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Healthcare Trend #3: Clinician Burnout and Patient Impacts

Approximately 63% of physicians report burnout at least once a week. Clinician burnout not only exacerbates staffing challenges and jeopardizes the health and well-being of frontline healthcare workers, it also poses critical risks to patient safety, care quality, and the long-term sustainability of HCOs. Burnout can lead to increased medical errors, compromised decision-making, and diminished patient-provider relationships, directly impacting the experience and outcomes for patients and potentially increasing insurance premiums and out-of-pocket expenses for members. Every departing nurse or physician deepens the cycle, as budget freezes and shortages in the workforce make it difficult, if not impossible, to replace these key personnel. As the pressure mounts, remaining staff and healthcare consumers all suffer – with longer wait times, reduced continuity of care, and overall diminished access to services, threatening the very stability of healthcare delivery systems.

Recommended Approach: Ease the burden on clinicians by first understanding teams’ day-to-day friction points. Engaging directly with end-users ensures their voices inform your modernization efforts, fostering a culture of collaboration that can drive meaningful change. This open dialogue cultivates powerful change advocates who will champion the adoption of digital investments, such as smart automation, trusted data, advanced analytics, and integrated consumer experiences. Furthermore, organizations must strategically engage and resonate with providers who are contemplating career transitions, ensuring that their needs and aspirations are addressed. These efforts not only contribute to your HCO’s bottom line but also enhance the overall experience for everyone—providers, patients, and caregivers alike. In both the short- and long-term, these initiatives will build trust within your consumer base, positioning your organization as a desirable destination for care and ultimately fostering a healthier, more engaged community.

See Also: Perficient Mentioned in Two Forrester Reports on Tech-Enabled Clinician Experiences

Healthcare Trend #4: Experiences That Build Trust

Research from Gallup showed consumers, in 2023, had some of the lowest levels of trust ever recorded in the healthcare industry. Although we are seeing levels of trust in HCOs begin to improve, they still have a long way to go. 2025 will see the continued push to meet healthcare consumers’ demand for convenience and personalized digital experiences.

Recommended Approach: From everyday commerce to the 2024 presidential election, we continue to see one clear fact: It’s imperative to know your audience. There is no “typical” healthcare consumer, and if you don’t treat people as individuals with unique, personal needs, you risk losing them to another HCO that does. Your organization must incorporate comprehensive healthcare personas and journeys to fully understand the people you serve, how they want you to communicate with them, and how they access your care or services — or risk losing them. Consider potential areas of mistrust for your organization and address them now to build consumers’ confidence. Key areas where we often help HCOs do just that are through digital front door strategies, implementation of intelligent search, and reimagining information architecture (IA).

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Healthcare Trend #5: Competition From Disruptive Healthcare Models

We’ve seen upheaval in the realm of healthcare disruptors — as Walmart has pulled out and Walgreens has pulled back, Best Buy has jumped in. Healthcare disruptors are finding out something traditional healthcare organizations (HCOs) have known for some time: Success in the healthcare industry is a complicated. But we are seeing disruptors to the traditional healthcare model find that success. Companies like Hims, Hers, and Henry Meds combine the best of empathetic, consumer-friendly language with convenient, powerful commerce experiences designed to help users way find and convert quickly.

Recommended Approach: Traditional HCOs that want to compete against successful disruptors require thoughtful, thorough business transformation. Take stock of your organization’s KPIs and how you are measuring success. Are you driving toward growth? If so, is it the right kind of growth to stand out? Next, determine whether you’re meeting the evolving expectations of today’s healthcare consumers. Be mindful of considerations around health equity and social determinants of health (SDOH) and align your strategies to match. Ultimately, we’re seeing powerful outcomes from organizations that shift from a project-focused model to a product-driven approach. Product-driven healthcare enables greater agility to respond to market shifts and fluctuations, as well as industry trends, the uncertainty of changes in healthcare regulation, and the demands of today’s consumers.

Read More: Is Your Healthcare Organization Really Product-Driven?

Healthcare Trend #6: Better Health Outcomes Through Shared Health Data

Efforts to reduce costs and improve health outcomes are driving collaboration among HCOs as health plans and integrated systems aim to more-holistically support consumer health, ease the care journey, and reduce the cost of care. Clinical data spanning an individual’s various provider relationships is crucial for a comprehensive patient view. Meanwhile, leaders continue to explore ways AI and automation can illuminate a 360-degree consumer view to power personalization, boost retention, and increase business resilience. These discussions are forcing focus toward data quality, consistency, governance, and bias.

Recommended Approach: Cloud services’ importance has surged to meet the growing need for real-time, accessible data. We recommend that HCOs continue building a scalable foundation to connect and integrate consumer data across health systems, providers, and insurers. This requires focus in several key areas, including data integration, data management. and data consistency and quality. Only then can data be richly woven into a reliable 360-degree view of the consumer that spans and supports better care management, marketing engagement, and support services. To optimize costs, we anticipate increasing adoption of data virtualization (a.k.a., Data as a Service, or DaaS). This unified data access layer approach bypasses the need to replicate data across various patient and member data management systems (e.g., data warehouses, MarTech, contact center, etc.), and offers a single view of enriched and transformed data from multiple data sources.

Explore More: Data-Driven Companies Move Faster and Smarter

Healthcare Trend #7: Care For the Aging and Underserved

An aging consumer base and a growing emphasis on health equity are reshaping patient engagement and business models for HCOs. According to the National Institute on Aging, approximately 85% of older adults have at least one chronic health condition, and 60% have at least two chronic conditions. In response, health insurers intensified focus on Medicare Advantage and Medicaid managed care plans to effectively serve a more diverse and underserved member population. Concurrently, providers are expanding into digitally connected services, such as telemedicine, remote patient monitoring, and personalized care plans, enabling patients to manage their health in more convenient and accessible settings. These shifts not only enhance patient experience and satisfaction but also foster a more inclusive healthcare system that addresses the unique needs of various demographic groups.

Recommended Approach: Deeply understand your patients’ and members’ journeys so you can deliver differentiated digital experiences in an increasingly crowded marketplace. Improve brand affinity with intuitive, personalized, accessible care moments that build trust (and bolster Star ratings). Intelligently automate systems and processes to optimize costs and build margin that can buffer potential shifts in reimbursement models. The integration of Social Determinants of Health (SDOH) data adds value by addressing factors like transportation, housing, and food security that impact health outcomes. Through a surround-care approach, powered with important health insights and intuitive tools, HCOs can strengthen community and individual health. This comprehensive strategy enhances engagement and trust while promoting better health outcomes and equity across diverse populations.

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Healthcare Trend #8: Mandate-Driven Transformation

Regulatory mandates continue to drive significant investment and effort from all HCO’s. Leaders strive to meet evolving requirements in CMS interoperability and prior authorization, price transparency, TEFCA, and others. Meanwhile, HHS insight on PHI and legal cases muddy the waters of HIPAA. In general, the effort to understand expectations, implement new functionality, and abide by existing mandates continues to increase. These mandates may seem simple at first, but they have significant implications as insurers work to incorporate patient data using standards common to the provider world. HCOs cannot simply repurpose hastily-constructed solutions from earlier mandates as a foundation for future compliance. Upcoming mandates are meant to build upon those that came before. Without a scalable approach and a thoughtful architecture, HCO’s will find themselves with an ever-increasing debt burden.

Recommended Approach: We encourage leaders to identify mandates’ silver lining opportunities. After all, to remain competitive and compliant, HCOs must innovate in ways that add business value, meet consumers’ evolving expectations, build trust, and deliver equitable care and services. Achieving transformative outcomes and health experiences requires a digital strategy that not only satisfies mandates but also aligns the enterprise around a shared vision and actionable KPIs, ultimately keeping patients, members, and care teams at the heart of progress.

Therefore, we recommend that HCOs approach mandates as a set of iterations, using a strategy-first approach that holistically considers the broader mandate and regulatory landscape. Keep a pulse on what other healthcare organizations – especially new market entrants and disruptors – are doing. Adapt digital best practices from outside of the healthcare industry. And deeply understand the nuance of interoperability standards, patient data modeling, API gateways, and SMART on FHIR applications.

The most successful organizations will build a proper foundation that scales and supports successive mandates. Composable architecture offers a powerful, flexible approach that balances “best in breed,” fit-for-purpose solutions while bypassing unneeded, costly features or services. Tactically, organizations can accelerate value, privacy, and data quality with secure, compliant, and modern technology platforms and data architectures. It’s also vital to build trust in data and with consumers, paving the way for ubiquitous, fact-based decision making that supports health and enables relationships across the care continuum.

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Expert Digital Healthcare Consulting Services: Imagine, Create, Engineer, Run

In this next decade, advances in digital health, growing consumerism, and mounting financial constraints will propel how HCOs shape experiences and deliver equitable, high-quality, cost-effective care.

Perficient combines strategy, industry best practices, and technology expertise to deliver award-winning results for leading health plans and providers:

• Business Transformation: Activate strategy for transformative outcomes and health experiences.
• Modernization: Maximize technology to drive health innovation, efficiency, and interoperability.
• Data Analytics: Power enterprise agility and accelerate healthcare insights.
• Consumer Experience: Connect, ease, and elevate impactful health journeys.

We are trusted by leading technology partners, mentioned by analysts, and Modern Healthcare consistently ranks us as one of the largest healthcare consulting firms.

Discover why we have been trusted by the 10 largest health systems and the 10 largest health insurers in the U.S. Explore our healthcare expertise and contact us to learn more.

Remember the days when robots and artificial intelligence (AI) were confined to the realms of science fiction? Fast forward to today, and AI in healthcare is rapidly transforming how we diagnose, treat, and care for patients. From intelligent algorithms diagnosing diseases faster than the human eye, to virtual health assistants providing round-the-clock support, AI is revolutionizing the healthcare industry. But with this technological revolution comes a host of challenges that must be guided by ethical considerations, data privacy protections, and ongoing evaluation to ensure equitable and safe patient outcomes.

What Is AI in Healthcare

Quick lesson – AI in healthcare refers to using AI technologies and systems to improve various aspects of healthcare delivery, including diagnosis, treatment, patient care, and operational efficiency. AI, by definition, involves the development of computer systems that can perform tasks typically requiring human intelligence. These tasks include learning, reasoning, problem-solving, perception, and language understanding. In the context of healthcare, AI technologies are applied to analyze complex medical data, enhance patient care, streamline operations, and improve decision-making processes for healthcare professionals.

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The Transformative Potential of AI

As I mentioned, AI in healthcare represents a transformative force, offering significant potential to improve diagnostics, treatment personalization, and operational efficiency. Some examples include:

• Enhanced Diagnostics: AI algorithms, particularly those utilizing machine learning and deep learning, are capable of analyzing medical images, pathology slides, and genomic data with high accuracy and speed. For example, AI systems can detect early signs of diseases like cancer or diabetic retinopathy that might be missed by human eyes. This can lead to earlier interventions and better patient outcomes.
• Personalized Medicine: AI can process vast amounts of data to identify patterns that inform personalized treatment plans. By considering a patient’s genetic makeup, lifestyle, and other health variables, AI can help tailor treatments that are more effective and have fewer side effects. This customization moves healthcare from a one-size-fits-all model to one that is patient-centered.
• Operational Efficiency: AI can automate routine tasks, such as scheduling appointments and managing patient records, freeing healthcare professionals to focus on patient care. AI-driven predictive analytics can also optimize hospital resource management, reducing wait times and improving service delivery.

Key Challenges and Considerations

As AI continues to transform healthcare, it brings with it a double-edged scalpel, if you will, capable of making groundbreaking advancements yet full of challenges and considerations. Let me shed some light on the vital considerations necessary to navigate this new frontier responsibly:

Ethical Concerns

The use of AI in healthcare raises ethical issues, such as algorithmic bias that can lead to disparities in treatment, based on race, age, gender, and socioeconomic status. Ensuring that AI systems are trained on diverse data sets and are transparent in their decision-making processes, with accountability for errors and outcomes, is crucial for fairness and equity.

Data Privacy

Healthcare AI relies on large datasets that include sensitive patient information. Protecting this data from breaches and ensuring compliance with regulations like HIPAA is essential to maintain patient trust and confidentiality. Also, patients may not be fully aware of how their data is being used by AI systems. Therefore, clear communication about data usage, as well as obtaining explicit consent, is critical to maintaining trust.

Human Oversight

While AI can support clinical decisions, it should not replace human judgment. Physicians should use AI as a tool to augment their expertise, ensuring that they remain accountable for patient care and can question AI recommendations when necessary. In addition, healthcare professionals need proper training to effectively utilize AI tools and interpret their results.

Strategic Implementation for Optimal Impact

Imagine building a house without a blueprint. It would be chaos and probably wouldn’t stay standing for very long. Similarly, implementing AI in healthcare requires more than technological prowess. It requires a strategic plan that ensures seamless integration, ethical considerations, and long-term sustainability. As part of this plan, healthcare organizations need:

1. Transformation Strategy: A successful transformation strategy for AI in healthcare involves aligning technological advancements with the organization’s overall mission to improve patient outcomes and operational efficiency. It begins with defining clear objectives, such as enhancing diagnostic accuracy or optimizing administrative processes, and securing leadership commitment. Investing in scalable technology infrastructure, ensuring data quality and security, and fostering a culture of innovation are crucial steps.
2. Collaborative Development: Developing AI solutions should involve collaboration between technologists, healthcare professionals, and patients. This multi-disciplinary approach can ensure that AI tools meet the practical needs of healthcare settings and address patient concerns.
3. Continuous Evaluation: AI technologies should be subject to continuous evaluation and regulation to ensure they meet safety standards and adapt to new medical insights. Post-implementation monitoring can help identify and rectify any unforeseen issues that arise.
4. Education and Training: Healthcare professionals must be trained to understand and work with AI systems. Education programs should focus on interpreting AI data, understanding its limitations, and integrating AI insights into patient care.

AI holds the promise of significantly enhancing healthcare by improving diagnostic accuracy, personalizing treatment, and increasing operational efficiency. However, this potential can only be fully realized if AI is implemented with careful consideration of ethical, privacy, and oversight issues. By taking a strategic and inclusive approach, we can harness the power of AI to improve healthcare outcomes while ensuring the technology is used responsibly and equitably.

Success Story: Improving Health Through Innovation and Technology

AI in Healthcare Expertise

Perficient combines strategy, industry best practices, and technology expertise to shape the experiences and engagement of healthcare consumers, streamline operations, and improve the cost and quality of care. Contact us to learn more.

Leverage AI to Drive Outcomes in Healthcare

Digital organizations in health payers and providers strive to enhance value for their patients and members.

And the stakes are high for these consumers. After all, healthcare decisions impact health, wallet, and emotional well-being. That means digital experiences become an important opportunity to positively fill gaps – both before and after care is received.

What does it mean to be truly product-driven in healthcare?

To be product-driven, healthcare leaders must launch and listen. Think of your digital products as a trusted source of consumer feedback to fuel your organization’s strategies, even beyond digital.

This is especially important in service industries where there is no tangible good. Your digital products become one of your most powerful assets.

Healthcare organizations often struggle to adopt a product-driven model.

The failures are easy to spot by looking at both the portfolio (top) and the team level (bottom) of the value creation funnel.

At the PORTFOLIO level, you need to ensure an ongoing collaboration to continuously refine and prioritize the business need/case.

• All parties should understand the intended impact of each business case on the organization.
• Digital leadership should be consulted for the anticipated impact on their digital products.

Healthcare is ripe with many disparate segments, lines of business, systems, and specialties. Often, these distinct areas will prioritize their own work and leave the difficult enterprise prioritization decisions up to shared services like digital.

At the TEAM level, you need to ask yourself an important question: are your teams “outcomes-obsessed.” If not, why? (Hint: often, there’s little incentive for outcomes-obsessed behavior.) Let’s look back to the top.

• Very few digital business cases ask for results, which makes the next challenge rather obvious: teams rarely use results to fuel ideation for the following planning cycle.
• This short-sighted approach perpetuates “launch it and leave it” mentality, resulting in:
  • Low utilization of digital products
  • Less-informed leadership teams across the organization

Your digital teams simply move on to the next priority (and, if you ask them, they may tell you that they feel like a factory).

A product-driven digital healthcare organization can tackle these problems at the top of the funnel.

Digital leadership must take place at the portfolio layer.

Digital product management leaders must have a collaborative relationship with stakeholders across various parts of the healthcare organization.

The business and digital leadership should:

1. Share and Gain Perspective

Peers across the business and partners in shared services (like digital) should be a) reviewing and discussing business hypotheses for new work and b) sharing analytics and other feedback from previous work. This kind of collaboration should inspire digital product management leadership to write their own Agile portfolio epics to aid in the organization’s varied goals of growth, retention, satisfaction, etc. Furthermore, all historical digital epic outcomes need to be shared with the business to help influence their work.

• Ideal Timing: This isn’t something merely done once a year; rather a forum to gain alignment and perspective should be on-going.

2. Create Well-Articulated Business Cases

The business hypotheses and intended outcomes should be made clear in draft Agile portfolio epics. The business and shared services, including digital, should come prepared with their best ideas.

• Ideal timing: Given the complexity in healthcare and insurance and the cyclicality of the annual funding process, this should begin no later than April with all drafts completed by end of May.

3. Refine

After sharing your drafted epics and listening to others, refine your business case with impacted leaders.

• Ideal timing: June and July

4. Prioritize and Fund

Tough decisions around what gets done with limited healthcare dollars is decided by the leadership in the project management office (PMO) and should be communicated across the organization. In healthcare organizations, this timeframe is critical to ensure that what you felt were solid business cases in May are still relevant in September.

• Ideal timing: September

5. Be prepared to pivot!

Given the dynamic nature of healthcare and health insurance, be prepared for a new business case at any time during the year (e.g., legislation, M&A, etc.). Depending upon the urgency, it should be scrutinized for its priority against formerly prioritized and funded work and/or the next planning cycle.

PRO TIP! If you are a digital leader who is constantly making tough prioritization decisions, scrutinize the portfolio or program epic for details. The expected business outcomes should help you make the decision. But if it’s political, share those facts back up to the business partners to make the final decision.

Product-Driven Success In Action

Perficient and GoHealth Urgent Care’s partnership has produced an award-winning and highly-rated mobile app that helps customers easily find an urgent care center, save their spot, and register for their visit.

Consumer experiences often lag in healthcare, yet GoHealth’s focus has consistently been to create the best possible consumer experience. Their commitment to Agile-driven product development, steered by user feedback and app analytics, ensures continuous improvement that prioritizes the highest-value features for their customers.

Move From Project to Product With Expert Guidance

Being a product-driven organization offers numerous advantages over being a project-driven one.

1. Defines and tracks business outcomes.
2. Leads to better business results.
3. Supports continuous improvement through iterative development.

Our VP of IT’s Guide to Transforming Your Business guide is an excellent resource for those seeking an even deeper dive. This guide answers IT leaders’ top questions about cloud strategy, data, DevOps, and product development. It comprehensively examines the latest trends and best practices for driving business outcomes through technology.

Interested in truly becoming outcomes-driven? We’re here to help. Learn more here.

In our previous article, we illuminated the significance of business transformation for life sciences and healthcare organizations (LS/HCOs). We delved into the anticipated value and pivotal roles these initiatives play in shaping a modern healthcare environment. 

Today, we unpack the steps LS/HCOs can take to actualize business transformation and the inherent challenges they might grapple with during the journey. 

Mapping the Path to Transformation 

Embarking on a business transformation journey requires strategic planning, fostering a blend of vision, technology, and agility. 

• Align Organizational Strategy and Leadership: Set the course by crystallizing the organization’s transformation vision and objectives. Leadership is instrumental here. By actively championing transformation, providing resources, and disseminating the vision, leaders pave the way for holistic change. 
• Assess Overall Readiness Take stock of the organization’s current transformation maturity, pinpointing areas of growth and needed enhancements. Prioritize change management, offering training and robust communication to mitigate resistance. 
• Break Down Silos: Foster transparency, flatten organizational structures, and ensure that valuable information is readily available across all units. This promotes collaboration and fuels innovation. 
• Focus On The Consumer: Root all actions in the needs of the consumer. Understand their expectations and tailor processes to enhance their experiences. 

• Implement an MVP Approach: Seek quick wins that align with business goals. Embracing an Agile methodology infuses the process with adaptability and vision. 
• Build Technical Foundation: Technology should serve business objectives. Integrate platforms and nurture a collaborative ethos between business and tech teams. 
• Organize Technology Around Data + KPIs: Deploy cutting-edge technologies like AI to leverage integrated data, measure progress, and adapt dynamically. 

At its core, successful business transformation harmonizes people, processes, technology, and organizational culture. As the linchpins of transformation come together, it’s essential to recognize and address the inevitable barriers that arise. 

Facing Transformation Head-On: The Challenges 

Transformation isn’t without its hurdles. Here are some predominant challenges: 

• Resistance to Change: Fear of change can manifest as reluctance to adopt new systems or procedures. Countering this demands clear communication and robust change management strategies. 
• Complex Regulatory Environment: The intricate web of regulations can complicate transformation. Complying with protocols such as HIPAA, GDPR, FDA, CFR 21 Part 11, and other privacy mandates necessitates meticulous planning. 

• Data Management and Interoperability: Given the vast data streams in LS/HCOs, ensuring data interoperability, quality, and security is paramount. Embracing data analytics tools and governance structures aids in converting this data into actionable insights. 
• Financial Constraints: The financial commitment for transformation can be steep. It’s vital to prioritize initiatives based on potential ROI and to seek out funding avenues. 
• Legacy Systems and Infrastructure: Incorporating modern digital solutions with outdated infrastructure can be a tedious endeavor. It’s essential to address these challenges for seamless data sharing and system operability. 
• Interdisciplinary Collaboration: Alignment among diverse stakeholders, from clinicians to IT experts, is crucial. A shared vision, open communication, and interdepartmental cooperation are pivotal to the success of transformation efforts. 

LS/HCOs can no longer sit on the sidelines and play the “wait and see” game. Business transformation is not a fleeting trend—it’s an essential strategy for organizations to remain competitive in a constantly evolving healthcare and life sciences industry. By embracing transformation, organize can thrive, offering superior care and member services, improved outcomes, and sustainable solutions in an increasing complex landscape. 

Your thoughts are valuable. Is business transformation in healthcare a fleeting trend or an imperative necessity? Contact us today to learn more about how we cater to your specific goals. 

Understanding: What is Agile? 

Agile is a set of principles and practices for project management and product development that emphasizes flexibility, collaboration, customer-centricity, and adaptability to change. The key principles of Agile include valuing individuals and interactions over processes and tools, working software (or deliverables) over comprehensive documentation, customer collaboration over contract negotiation, and responding to change over following a plan. 

Agile methodologies, such as Scrum, Kanban, and Lean, provide specific frameworks and practices for implementing these principles, allowing teams to work iteratively and incrementally to deliver value more effectively and efficiently. 

Steps to Adopt an Agile Stance in Healthcare 

Transitioning an organization to Agile demands shifts in culture, processes, and mindset. For healthcare entities, this change is intensified by stringent regulations, intricate procedures, and the vital importance of patient care and member services. 

Nonetheless, Agile can enhance efficiency, patient outcomes, and both member and employee satisfaction in these sectors. Here are steps to transition into an Agile healthcare or life sciences organization: 

Build a People-Centered Foundation 

• Champion Leadership: Leadership commitment is crucial. Leaders must articulate the vision and allocate resources for Agile initiatives.
• Formulate Agile Teams: Assemble interdisciplinary teams, emphasizing collaboration for maximum value delivery.
• Educate & Train: Prioritize Agile education to align teams with its principles. 

Enact Your Agile Framework 

• Pilot Agile Projects: Commence with specific departments to assess Agile’s impact and advantages. 
• Incorporate Agile Practices: Introduce regular Agile methodologies like daily stand-ups and sprint planning, tailored to healthcare specifics. 
• Adhere to Regulations: Ensure Agile processes align with healthcare regulations like HIPAA. Compliance and data security are paramount. 

Iterate and Evolve 

• Center on the Consumer: Enhance care and services by actively involving patients and members in feedback loops. 

• Promote Continuous Improvement: Nurture an environment where teams consistently evaluate and refine processes. 
• Leverage Data for Decisions: Harness analytics for actionable insights and resource optimization. 

Build and Sustain Progress 

• Boost Collaboration: Foster a culture of consistent collaboration and transparency across functions. 
• Invest in Agile-Compatible IT: Streamline IT systems, such as EHR, to support Agile workflows. 
• Expand & Share Success Stories: Build momentum by showcasing Agile’s success. 
• Gather Feedback: Regularly assess the impact of Agile on patient satisfaction and operational quality. 
• Adapt Agility: Stay prepared to refine Agile practices considering evolving industry needs. 

The Agile Advantage in Healthcare 

As healthcare and life sciences face evolving demands in patient and member needs, regulation, and technology, the merits of Agile become more evident. 

Agile’s core strength lies in its emphasis on consumer-focused offerings. By actively involving patients in decisions, tailoring care to individual needs, and promoting transparent communication, Agile not only enhances efficiency but deeply resonates with the member/patients’ unique needs. This approach elevates patient satisfaction and fosters healthier communities.

In an Agile environment, interdisciplinary teams unite, shattering operational silos. Such synergy is pivotal for tackling healthcare’s multifaceted challenges, enhancing care coordination, and amplifying efficiency.

Agile’s adaptability is crucial, allowing organizations to stay on top of shifting trends and regulations in the dynamic healthcare landscape. 

Benefits also encompass operational efficiency, cost management, and nimbleness in regulatory compliance. Agile’s iterative nature aids in early risk identification, ensuring care and services uphold rigorous standards, even within tight regulatory confines. 

Given the industry’s ongoing transformation, adopting Agile principles is not just beneficial, but vital for upholding superior care, services, quality, and outcomes. 

Need Guidance?

We specialize in crafting strategies and solutions for healthcare organizations that prioritize outcomes and enhance care team experiences. Contact us today, and let’s talk about getting you a tailored plan to suit your specific needs.