In 2013, the Affordable Care Act (ACA) had a profound impact on the Big Data segment, particularly affecting payers and employers. The introduction of public and private exchanges heightened the need for accurate recordkeeping and effective plan management, especially as employees transitioned from self-funded plans to private exchanges. Enterprise data management became even more critical for handling compliance mandates, ensuring that payers could efficiently manage a fragmented marketplace with diverse consumer needs. The challenge was clear—payers needed scalable, agile data management solutions that could provide real-time responses while mitigating risk and maintaining compliance.
Despite these changes, a key expectation for 2013 remained unmet. The importance of data management in the evolving healthcare landscape was not as widely recognized as anticipated. The technical issues during the rollout of public exchanges underscored the necessity of a strong data foundation with consistent workflows. The need for structured, reliable data became evident, but the full shift toward recognizing data management as a fundamental requirement was slower than expected.
Looking ahead to 2014, a major trend shaping the industry was the push for data consolidation. Payers aimed to unify multiple data sources into a single, streamlined perspective, partly driven by the Medical Loss Ratio (MLR), which limited non-claims administrative expenses. This shift opened opportunities for cloud-based solutions, offering a cost-effective approach to IT management. A well-structured data environment allowed payers to leverage analytics for deeper customer insights, particularly within exchange environments where access to centralized and consistent data was crucial.
One emerging target market was the “young invincibles”—healthy young adults whom payers needed to attract to balance their risk pool and control costs. With a well-managed data repository, payers could analyze sales data and test different service offerings to determine the most effective strategies for engaging this demographic.
Customer spending in the Big Data segment was expected to rise in 2014, with healthcare IT expenditures for payers and providers projected to exceed $34.5 billion. Regulatory requirements under the ACA and the necessity of adapting to a changing consumer market were key drivers of this increase. As payers transitioned from legacy systems to modern solutions focused on data management, analytics, and efficiency, investment in Big Data solutions became an essential part of staying competitive.
For the company, 2014 represented a year of growth and continued innovation in the payer market. Expanding the reach of cloud-based, SaaS solutions for benefits plan management and healthcare compliance remained a priority, ensuring that payers could remain competitive, compliant, and market-ready in the post-ACA landscape. With patented technology that streamlined data management by allowing changes to be made once and applied across systems and documents, the company had already helped large clients achieve significant cost savings through automation.
Another focus area was supporting Fortune 500 employers navigating ACA-driven changes, including decisions around private exchange transitions. Additionally, marketing efforts targeted payers seeking to expand their Medicare Advantage (MA) footprint, an area where regulatory compliance was paramount. With CMS projecting Medicare claims data to grow from 370 terabytes to 700 terabytes by 2015, and Medicaid data expanding from 30 terabytes to 100 terabytes, the ability to manage big data effectively was crucial. Without a comprehensive benefits plan management system serving as a single source of truth, big data could become an overwhelming challenge rather than an opportunity.
By centralizing and optimizing plan data management, the company aimed to provide payers with a competitive edge, reducing errors, avoiding costly penalties, and enabling faster responses to market demands. In an industry where regulatory oversight and consumer expectations continued to evolve, investing in scalable, intelligent data solutions was no longer optional—it was a necessity.
