Agile transformation in healthcare insurance industry

Overview of the healthcare insurance industry and agile transformation

Task:

Healthcare insurance industry face constant pressure of technological changes which directly impact overall customer experience, innovative product development and services that are offered.  (Kalyan Jonnalagadda, 2019). Agile transformation in healthcare insurance industry would focus on how some of the leaders are enforcing importance of agile innovation team within organization to keep up with the current trends of technology. Learning how agile has progressively changed healthcare industry and modernized the platforms with innovative products is new to the project management field since that would create a new opportunity in the field. The idea of agile scrum can carve the future of healthcare technology related products into better human living is a proof how a methodology can be transformational in such short period of time.

Healthcare companies must keep up with changing customer needs and technological advancements that surrounds customer day to day health-life; to keep up with this companies are becoming more agile than ever. Products like healthcare advise by texting and doctors on demand are becoming more in demand with consumers and healthcare companies are competing to be at the forefront or pioneer of new technology to acquire consumer market. All of this is possible provided companies adopt agile approach and as Jonnalagadda said ‘Having the best product is no longer enough without improving the services and experiences surrounding it’ (Kalyan Jonnalagadda, 2019). Agile provides that flexibility to develop, test and adopt faster in the rapidly changing healthcare insurance market; thus, companies taking advantage of transforming their teams in this direction would win the market.

The overall problem that will be focused are in the area of how healthcare insurance industry is changing and the consumer products around that are being built. Vertical industry such as medical devices, payers side transformations (hospitals, institutions) and pharma medical industry would be focused as well since all of these are intra-connected to a common consumer. The overview of the healthcare insurance industry and agile transformation can also be focused from the drug manufacturing to patient care management and how insurance companies are bringing technological changes to consumer market by adopting agile project management methodology. Another area that would be assessed is if the cost and time of developing healthcare products have decreased by just changing the methodology of product development lifecycle.

Bresnick believes that ‘Organizational resistance to new strategies is a common pain point, and leaders without a firm understanding of health IT can sometimes create roadblocks to innovation, intentionally or otherwise’ (Bresnick, 2018). Leaders often discuss adoption of agility within their team, but they often get resistance at the time of implementation enterprise wide. Moreover, Scaling in agile is also extremely important and some of the advantages of doing that could possible increase return on investment and decrease the cost of product; ultimately resulting in companies being able to keep up with the market trend and deliver better customer oriented product in time. It is now vital that agile methodology to be considered for faster IT development for insurance companies to catch up with the competition and create more innovative products for consumers.

Agile methodology in healthcare product development

Healthcare industry is exceptionally close to human creatures' job; requiring and testing healthcare organizations ordinarily to give better and quality life. Increasingly more Healthcare associations are tolerating agile technique to cover zones like government guidelines, quality items/gadgets and to give better healthcare to individuals. Agile change in healthcare industry would set patterns for its vertical industry accomplices, for example, medicinal gadgets, pharma organizations and mechanical new companies which would be tried to embrace a similar venture wide agile methodology in their PMO.

Good research starts with a question to answer or a problem to solve. Your problem statement forms the basis of your entire research paper; therefore, it should be the first part of the paper to be written. It should begin with a clear and concise statement of the problem, and then provide additional detail and justification as to why it is an important issue to be solved. This section should be 2 to 3 pages in length and contain the following:

1.Problem statement – 1 to 2 sentence description of the problem to be solved.

Clear - provides enough information to be easily understood
Concise- expressed in the fewest possible words
Focused – narrow enough to be answered in the scope of the paper
Relevant – shows a relationship to the field of project management

Note that your problem statement may be, or include, a question to be answered. You may want to list your primary research question and any secondary questions that arise from it.
2.Justification – discussion of why it should be solved. This section should include the reasons why this problem should be solved and/or the consequences of not solving it. You should briefly reference and cite any relevant research to support your claims.
3.Hypothesis (optional) – proposed explanation, solution or suggested outcome. Some research will contain a hypothesis to be tested or explored. This may not apply to all research.
4.Limits (optional) – what the research paper will NOT cover. Note any boundaries, exceptions or limits to your research.


Healthcare insurance industry is one of the most complex and restricted industry tied to human health. Thus, health care insurance companies and organizations would benefit the most if they embrace the agile methodology within their team to build member-centric products. Insurance companies have complex systems with managing payers and insured members interacting everyday through technology to render services such as medical or non-medical; all of these have affecting factors such as changing government regulations; payors platform and customer expectations with insurance products. Therefore, healthcare insurance industry is always facing changes and for these reasons older software development lifecycle methodologies such as waterfall is not enough for obtaining sustainable changes in healthcare insurance industry.

Challenges faced by healthcare insurance companies

Most of the healthcare insurance industry is already in the process of adopting Agile Methodology’s values looking at the benefits. Healthcare insurance’s processes have been established out of the necessity and sometimes the projects that are being planned are now facing constant pressure to be managed in advanced with contracts deployed.  Moreover, Agile methodology’s main case is to look for design and development processes that are proficient to being adoptive of constantly changing needs of healthcare insurance industry while being efficient and responsible.

Insurance organizations can fast track the idea of adopting agile methodology by embracing new ideas through following key points obtained from agile methodology: developing products that are user centric and resolves the problem with providing key metrics and further enlightenment into future problems to be solved; authorizing team to develop products that are cooperative, methodical approach and can be tested as prototype; incorporating new ideas from the members, technology and knowledge. Continuous improvement with development and testing is an essential part of the process to develop new tools that cover member experience.

Primary research of this paper would be focused on discussing 1) Agile adoption and transformation in healthcare industry 2) Scaling of agile in healthcare industry 3) Vertical healthcare industry impact of agile methodology. Executives and leaders talk about adopting agile but as Jonnalagadda claimed in his research that close to 80% executives said they need to more agile but still half of them did not understand the methodology and tools or are not using it within their teams  (Kalyan Jonnalagadda, 2019). Executives are talking frequently about their team going agile but most of those lack the sense of implementing it in practice. This shows a wide problem of companies not being able to adopt methodological change in their teams and how it needs attention to solve it. Healthcare executives now need to take a broader view on insurance industry processes and see where agile can transform processes and bring innovation such as provider services, customer experience and internal claims adjudication processes. Most of the executives whose teams have adopted agile methodology can see the transformation on how their team is

The consequences of not adopting Agile in healthcare industry could be disastrous as some of the companies who continue to work within waterfall methodology would fall behind with the market competition. Some projects taking time of 12 to 24 months to deliver the product which would again lack user testing and feedbacks and a lot of back and forth development and testing to be required for delivering the right product. Some of the major impacts could be losing market share in insurance industry; bad customer experience, employee dissuasion and worst of all failing business from customers. Thus, nowadays adoption of agile is now becoming a requirement for leaders to run their business processes successfully and business success.

Your literature review is the theoretical basis of your research paper. It establishes a link between your specific topic and what research has already been done about it. Your literature review should show how your research and/or findings contribute to the existing body of knowledge related to your topic. It should provide the reader with a holistic view of your research, showing a synthesis of all your references (as opposed to an annotated bibliography that details each source one by one). Your literature review should be 8 to 10 pages in length and be organized in logical way. Your literature should meet the following criteria:
1.Contain 10 to 20 scholarly sources such as journal articles, books and papers.
2.Contain research that is relevant and timely (resources should be related to your topic and most should be less than 5 years old).
3.Provide a thorough summary and analysis of previous research about your topic.
4.Be organized in a coherent way (theme, chronological order, order of interest).
5.Identify gaps in the research or areas to expand the existing research.
6.Contain and introductory and conclusion paragraph.