Top 7 Healthcare Focus Areas for Mastering Modern CPQ Technology in 2024
Sri Tella, Sr. Director of Technical Product Management at McKesson

Worldwide, today’s leading healthcare organizations are embracing digital transformation. The implementation of Configure, Price, Quote (CPQ) solutions is a major component of these business evolutions. Any organization aiming to enhance operational efficiency and bolster patient care now sees a finely-tuned CPQ system as table stakes. With an eye toward the future, healthcare and life sciences (HLS) organizations integrating CPQ are set to fundamentally alter traditional care delivery and management models.

With that in mind, let’s take a look at eight key trends and features reshaping CPQ in healthcare.

1. AI-Driven Personalization for Enhanced Patient Care

The integration of Generative Artificial Intelligence (GenAI) with CPQ systems marks a significant shift toward delivering personalized healthcare services. By leveraging algorithms to analyze comprehensive patient data sets—from medical histories to lifestyle preferences—CPQ platforms can now help craft tailored treatment quotes. This advancement ensures that healthcare services are individualized to a patient’s unique health profile and delivered in a manner that prioritizes empathy and patient-centricity.

Example: Leveraging GenAI, a CPQ system processes a patient’s complete medical profile to propose a customized treatment plan for diabetes management. The plan includes medication, lifestyle modifications, and scheduled consultations, all priced dynamically based on the patient’s insurance coverage and eligibility for financial assistance programs.

Remember: Integrating AI into CPQ systems ensures that healthcare services are customized to the individual, elevating the standard of patient care.

2. Leveraging Predictive Analytics for Dynamic Pricing

Predictive analytics has transformed CPQ systems into dynamic pricing engines capable of adjusting healthcare service costs in real time. By analyzing data on market trends, regulatory updates, and patient demographics, CPQ platforms can fine-tune pricing models to remain competitive while ensuring services are accessible to a diverse patient base.

Example: A healthcare provider (HCP) uses predictive analytics with GenAI/CPQ to adjust the cost of elective surgeries based on seasonality, insurance rebates, and patient influx, ensuring optimal occupancy rates and patient affordability.

Remember: Dynamic pricing through predictive analytics allows healthcare providers to offer competitively priced services tailored to the market and patient needs.

3. CPQ’s Crucial Role in Value-Based Care

In today’s shift towards value-based care, CPQ systems emerge as essential tools for designing service bundles that prioritize patient outcomes over traditional service-based models. This approach aligns pricing and treatment plans with the overarching goal of improving patient health outcomes, marking a departure from fee-for-service models.

Example: A CPQ platform enables a cardiology clinic to bundle diagnostic tests, consultations, and follow-up care into a single, outcome-focused package. This bundled approach simplifies billing for patients and aligns the clinic’s services with the goal of reducing hospital readmissions for heart disease patients.

Remember: By aligning service offerings with value-based care principles, CPQ systems are pivotal in prioritizing patient health outcomes.

4. Virtual CPQ Solutions Bridge the Accessibility Gap

The expansion of telehealth services and remote consultations necessitates the development of virtual CPQ solutions adept at managing online healthcare delivery. These platforms ensure precise billing and service documentation for telemedicine, accommodating the unique requirements of remote care delivery and enhancing access to medical services.

Example: A mental health service provider employs a virtual CPQ system to manage and bill for a series of cognitive behavioral therapy (CBT) sessions delivered via telehealth. This system facilitates seamless service delivery to patients in remote areas, eliminating geographical barriers to access.

Remember: Virtual CPQ solutions are instrumental in extending healthcare services to underserved populations, ensuring quality care is accessible to all.

5. Blockchain for Secure and Transparent Healthcare Transactions

Blockchain technology introduces a new era of security and transparency to CPQ systems in healthcare. By creating a decentralized ledger for all transactions, blockchain ensures that patient data, billing information, and contractual agreements are secure, immutable, and transparent. This level of security protects sensitive information and builds trust among patients and providers by guaranteeing the integrity of every transaction.

Example: Implementing blockchain technology, a hospital’s CPQ system securely records patient consent, treatment plans, and billing details for surgical procedures. This record is immutable and easily verifiable, providing patients with transparent access to their treatment histories and financial transactions.

Remember: Blockchain integration within CPQ systems enhances the security and transparency of healthcare transactions, fostering trust in digital healthcare services.

6. Navigating Regulatory Compliance with Agile CPQ Systems

With healthcare regulations constantly evolving, CPQ systems have become pivotal in ensuring that organizations remain compliant. These systems are designed to be agile and easily updated to reflect new documentation standards, privacy laws, and compliance measures. This agility helps healthcare providers quickly adapt to regulatory changes, safeguard patient data, and maintain operational integrity.

Example: A CPQ system is updated to include new General Data Protection Regulation (GDPR) compliance measures, automatically incorporating enhanced patient data protection protocols into every quote and agreement process. This ensures the organization stays ahead of compliance requirements, protects patient information, and avoids penalties.

Remember: The agility of CPQ systems in adapting to regulatory changes is essential for maintaining the compliance and integrity of healthcare operations.

7. Enhancing User Experience with Intuitive CPQ Platforms

Modern CPQ systems prioritize the user experience (UX), featuring intuitive interfaces, mobile compatibility, and advanced collaboration tools. These enhancements make CPQ platforms more accessible to healthcare professionals, streamlining the quoting process and facilitating better patient interactions. An optimized UX encourages wider adoption of CPQ systems, ultimately improving the efficiency and effectiveness of healthcare service delivery.

Example: A CPQ platform with a user-friendly interface allows an HCP to quickly generate a quote for a patient’s treatment plan on a tablet during a consultation. This immediacy improves patient engagement and satisfaction by providing straightforward, upfront information about treatment options and costs.

Remember: An intuitive and user-friendly CPQ system improves operational efficiency and patient interactions, enhancing the overall quality of healthcare services.

The push for interoperability in healthcare is mirrored in CPQ systems designed for seamless integration with other digital health platforms. This interconnectedness allows for a collaborative approach to patient care, facilitating the exchange of information and coordination of services across different providers. CPQ interoperability breaks down silos within the healthcare system, enabling a more cohesive and efficient patient care experience.

Example: An interoperable CPQ system enables seamless data exchange between a hospital’s Electronic Health Record (EHR) system and a specialist clinic’s treatment planning tool. This ensures that a patient’s care plan is comprehensive and coordinated across multiple touchpoints, improving treatment outcomes and patient satisfaction.

Remember: Interoperable CPQ systems foster collaboration within the healthcare ecosystem, ensuring that patients receive well-coordinated and comprehensive care.

Future of CPQ Systems in Healthcare

The transformative potential of CPQ systems in healthcare is immense. They offer a pathway to more personalized, efficient, and transparent care delivery. As healthcare providers embrace these emerging trends, they unlock new possibilities for improving patient outcomes, operational efficiency, and regulatory compliance. The future of healthcare, powered by advanced CPQ solutions, promises a landscape where technology and care converge to meet the needs of patients and providers alike.

About Sri Tella

Sri Tella is the Senior Director of Technical Product Management at McKesson, and leads transformative CPQ initiatives for Healthcare and Life Sciences organizations. She specializes in legacy migrations and the optimization of cloud technologies for sales and operations teams.