Health plans: A better way to think about your digital business case

There are two potential “wins” that can come from just about any financial investment a health plan makes. The first, simply, is the likelihood that something will happen, the extent to which the investment produces your desired outcome. The second win stems from the first—it’s the outcome if everything goes according to plan, and it begs the question: If the result is exactly what you’re hoping for and checks all the boxes of what your customer base wants, what’s the payoff? Increased revenue and lower costs? How much? Will you instantly become the market leader? 

Neither kind of “win” is always clear-cut, and the truth is most investments—whether in the development and launch of new products or in improvements to underlying technologies along your organization’s digital journey—don’t revolutionize an industry or dramatically change a particular company’s fortunes. 

Defining success can’t be an all-or-nothing proposition, founded purely on hard data and stubborn expectations. Rather, what’s needed is a strong business case that includes a healthy mix of both quantitative data points and qualitative analysis spread out over time. It’s what you do when you win. 

A business case you can rely on 

If you’re a leader looking to gain traction across your organization around a new financial investment, you know that it all starts with the business case, where you’ll not only define precisely what you’re trying to achieve and why, but also outline the series of small bets you’re willing to make in order to get there. 

As you’re putting that business case together, it’s likely that quantitative figures may not be available to a degree that indicates certainty in a particular outcome or set of outcomes. For this reason, we’ve found that qualitative evidence backed by a number of supporting factors can increase confidence up-front and set your initiative up for success. 

Put another way, your business case should be built around: 

• Clear definitions of what you’re trying to solve for: Make sure the end goal is clearly stated. Whether the project will require building buy-in at all levels, specifically tracking value toward goals, and/or embracing a strong change management approach, any strategic plan must have its main goal top of mind.  

• Reaffirming metrics that clarify the scope of your project: What will you need in terms of time, personnel, and budget to reach your goals? While this may change over the course of the project, a detailed identification of basic requirements is, of course, indispensable.  

• Plans for testing out proofs of concept in smaller chunks: Quick wins have value, too—a great deal of value, in fact. An iterative, flexible approach allows you and your teams to build up to the ultimate goal, while learning and pivoting along the way. 

• An intentional working-backward from the anticipated outcome: What should “winning” actually look like? Begin there, and work back to set specific deadlines, identify target customers, develop a marketing plan, and delegate responsibilities for actions within the project. 

Increased comfort and confidence in the ability to execute 

A business case doesn’t magically guarantee success, of course, but success does depend on a strong one. It’s essential to keeping your initiative on track by clearly defining what you’re trying to solve for while also increasing confidence in the payout when you “win.”  

If you’re a health payer organization looking at spending $1 million to design, develop, and launch a new digital product in response to a competitor’s new offering, for example, you’d want to address the quantitative cost-benefit analysis of the endeavor and how it fits into your organization’s overall scheme and strategy. And you’d also want to be sure the new product’s qualitative value—to your organization, your customers, and all other affected stakeholders—is fully articulated. What will the market response be? Will it add to your organization’s tech debt or will it be part of your digital transformation? How will the benefits of this product launch materialize?  

Questions like these don’t necessarily have clear-cut answers, especially up front, and they don’t always need to. But folding them into your business case as part of what will be affirmed once the initiative is underway will help minimize analysis paralysis and keep progress tied to specific, value-oriented milestones. 

Conclusion 

Business cases will need constant attention, revision, and updates as the project moves forward. This is what digital organizations do—they treat their business cases like living, breathing aspects of their operations. Because “winning” isn’t 100% guaranteed, a leap of faith might be necessary, whether at the outset or at several points along the way. Those are the moments when the backing of the qualitative evidence gathered within a business case will pay the greatest dividends, giving you and your teams confidence in the endeavor whether deeper metrics aren’t as readily available. In this sense, it becomes a matter of taking on the psychology of an entrepreneur, pushing forward on the strength of a solid, yet pliable foundation that acknowledges uncertainties without getting hung up proving the as-yet unprovable. 

No matter where you are on your journey—beginning to build out a business case or looking for qualitative factors within an existing one—it’s imperative to focus on the factors that matter. Though we’re no strangers to the power of data, there’s no algorithm to ensure a project’s success before it has begun.  

So, what do you win when you win? Hopefully it’s ultimately the usual payouts: market share, increased revenue, and cost savings, to name a few. 

But you should also win confidence in the value of a thorough business case and bold, iterative, cost-conscious approach to investing in a project or initiative that’s poised to have lasting impacts on your business and market.