The healthcare payer ecosystem in the United States has changed dramatically over the last decade and is expected to evolve at an even faster pace over the next few years. Many world-class companies involved in healthcare payment processing are finding themselves constrained by their existing information technology infrastructure. The silos that they built around business-to-business (B2B) processing are constraining them, making it difficult to achieve governmental mandates and (more importantly) increase processing efficiency and competitive advantage. Gone are the days of a small set of data following static and simple standards traded between a limited set of organizations.
Gone are the days where the rules for when data is valid versus invalid can expressed in a paragraph or two. Gone are the days when information about a healthcare payment was almost entirely about the "who," "when," and "how much."