Health Care Reform Requires IT Solutions to Influence Consumer Perception at a Health Care Payer

Recent health care reform is one of the biggest changes that the health care industry has ever faced. This reform represents paradigm changing opportunities and challenges for the company providing health insurance in a managed care environment. The CIO of a premier managed care health insurance provider (ABC Company) wants to take advantage of the new environment using Information Technology. He and his management teams have determined, using primary research, that the customer perception of the health care company’s cost and accessibility to quality health care are the most important factors to their customers in the new market. They are aware that even though they have been able to use information technology to predict customer reaction to changes in cost and perception of quality, it will be very difficult to deliver new systems and processes that support ABC Company’s exposure to the new realities it faces in the market. ORGANIZATIONAL BACKGROUND A debrief from a consulting firm about the recent health care overhaul legislation caused the CIO of a premier managed care health insurance provider (“ABC Company”) to conclude that this health care reform was a significant change for the health care industry and his company in his living memory. The reform was not only significant in providing health care access to more than 32 million additional individuals but also would force the health insurance companies to rethink Rahul Bhaskar California State University – Fullerton, USA Au Vo Claremont Graduate University, USA DOI: 10.4018/978-1-4666-4619-3.ch003