3 Challenges Healthcare Payors Are Already Overcoming with Workday

02.19.2025 | Technical Articles

How do healthcare insurance companies stay profitable with constant external pressure? Changes to short-term health insurance rules, rising customer expectations, emerging class-action lawsuits for AI usage, and other challenges are making it harder for insurers to control costs.

More often, we see the answer to the cost-efficiency question is choosing the right enterprise cloud applications. Specifically, more healthcare insurance companies are finding Workday overcomes their challenges, budgetary or otherwise, by integrating their financial management, human resources, planning, and other essential functions.

What quick hurdles can Workday enable health payors to overcome? Here are three ways this enterprise platform is advantageous to health insurance leaders.

1.) Unified Management

Though the goals of HR and finance leaders vary significantly, the two functions have plenty of shared interests. In fact, when they are working within a unified platform, both groups can proactively collaborate on their intersecting initiatives.

HR and finance teams need to prepare for overlapping requirements. When employees receive raises, move to new states, or are terminated, both departments need to process their interconnected responsibilities seamlessly. When HR updates their employee benefits package or pursues new policy initiatives, they need a streamlined way to get approval and allocation of essential funds from the finance department. These and other instances justify a multifaceted enterprise solution.

For example, creating a unified system positively impacted Healthfirst, a New York based health insurance company. Before choosing Workday, they were splitting finance and HR operations between systems, which prevented levels of cooperation and streamlined expenses they didn’t even know they were missing.

There’s even a chance to integrate redundant financial systems. CNA was able to consolidate five legacy platforms into one cloud-native system, contributing to 30% annual savings on system expenses.

2.) Real-Time Reporting and Planning

Executives and other health insurance decision makers need access to up-to-the-minute reporting and insights. Without timely financial reports, leaders might hesitate to make decisions that impact their financial growth, services, and policies. Plus, the ability to model and forecast based on streaming data in the wake of new regulations, customer pain points, and technology trends is indispensable.

For those reports to be well-timed, healthcare payors need a single source of truth (that includes policy revenue, premium investment revenue, AP, AR, and other financial data) and real-time data streams to maximize shareholder value. All the data aggregation and reconciliation necessary for accurate and consistent reporting takes time and effort, meaning manual efforts result in stale insights.

Workday’s intelligent data core automates the aggregation and preparation of this crucial data so you can instantly queue up game-changing insights. Intelligent data core can integrate customer, billing, treasury, and even external data into a single source of truth. Then, you can drill into an array of reports whenever you want.

So, if you wanted to evaluate Gross Revenue by Revenue Category for the last two years, you can instantly see how premiums invested in U.S. Treasuries vs corporate bonds performed. Or if you wanted to see if there was a spike in Medicare Advantage enrollment after a recent digital advertisement campaign, you can quickly see if there was traction or not. Whatever your financial question, you’ll get up-to-date answers.

3.) Enhanced Compliance and Risk Management

Since regulations are always evolving, financial platforms need to take precautions to grow and expand with compliance in mind. The emergence of artificial intelligence, for example, has generated several prominent legal challenges across industries. In the health insurance world, class-action lawsuits against United Healthcare and Humana, alleging AI integrations increased coverage claims denials against elderly and chronically ill patients, are stirring up fear about heightened risk.

Workday Finance can help to assuage some of those fears about risk management. This enterprise cloud platform offers built-in controls and audit trails to policy-level details. Workday’s data lineage offers transparency that can help organizations review the decision-making process to reduce biases or potential liabilities.

Moreover, Workday has been used to help insurers apply risk scores to suppliers, helping to simplify the selection process. When Healthfirst implemented Workday, they were able to decrease overdue supplier invoice inquiries by 93%, going as far as to decrease the risk from existing partnerships.

Plus, all Workday products are compliant and/or certified with various security and privacy regulations:

Health Insurance Portability and Accountability Act (HIPAA)
TRUSTe Enterprise Privacy & Data Governance Practices
SOC 1, SOC 2, and SOC 3

How to Maximize Your Workday Finance Implementation

Though health insurance companies can derive clear benefits from adopting Workday Finance, there’s one challenge to overcome: maximizing your implementation.

Bringing out the best features of Workday requires an experienced partner ready to:

Oversee the implementation
Customize security to fit your needs
Clean up and migrate data into Workday
Establish test logistics and test scenarios
Create thorough documentation for knowledge transfer
Offer dedicated post-live support

With this level of dedication, you’ll be able to get the most out of your Workday investment, preparing your business to overcome the challenges and seize the opportunities facing the health insurance industry, now and in the future.