5 Non-Negotiables to Expect from Your Health Plan Portal Vendor

Choosing a new health plan portal is a big decision. It impacts the digital look and feel of your organization for years to come. And it could drastically affect your administrative costs, the quality of your members’ care, member satisfaction, and your employees’ day-to-day workflow.

So it’s important that you choose your health plan portal vendor carefully. You don’t want to make a huge commitment to partner with an organization you can’t count on. And you don’t want to invest in a product that can’t deliver what you need.

To help you narrow your options and find a vendor you can rely on, we’ve broken down five non-negotiables your vendor has to be able to do for you. As you vet your top choices, make sure you investigate these areas.

1. Contractually guaranteed reliability

Imagine if your providers weren’t contractually obligated to help you meet compliance standards and deliver better care. Without value-based contract measures, your providers could have a serious negative impact on your goals, and there would be nothing to hold them accountable.

Health plan portal vendors obviously don’t provide care, but they play an important role in helping you facilitate it. If a vendor won’t guarantee how much time their server will be up in running, it’s possible that they don’t have the necessary infrastructure, expertise, or staff to operate at their scale. But at the very least, it means they won’t own up to their mistakes, even when they cost you.

Guaranteed uptime is a must. But it’s not the only guarantee you need to have built into your contract. If your portal gets breached and your data is stolen, your members won’t blame your health plan portal vendor, they’ll blame you. Even if it’s not your fault. You can’t afford to let a vendor sabotage your reputation with low security standards.

Most vendors are incredibly dedicated to cybersecurity. Their livelihood depends on their ability to keep your members’ information safe. But you shouldn’t just put your faith in that principle. Make sure your contract includes stipulations about HIPAA-compliance and cybersecurity so they have an extra incentive to protect your data.

2. Rapid scalability

One of the biggest benefits of using a third-party health plan portal is that they should already have the necessary staff and infrastructure in place for you to launch your portal, and they should already have a product that can operate on the scale you need. That alone can shave months or even years off the time it will take you to launch your new portal.

Every month that your organization either has no portal or an outdated one, it costs you money. If your current digital solutions aren’t reducing the burden on your administrators and your members are still handling basic transactions over the phone or in-person, you urgently need a viable portal.

A vendor’s size and experience could significantly impact their ability to scale their technology in a timely manner. So be sure you compare the number of health plans each vendor is currently supporting, and explore their timeline for launching before you commit to a vendor.

3. Outstanding customer support

Even if nothing goes wrong, you’re bound to have times when you need quick access to support from your vendor. Rolling out a new system takes a lot of training, and you need to know you can count on your vendor to not just be available, but to proactively ensure your employees have everything they need to be successful.

And of course, if you do run into problems, you need to be able to count on your vendor to resolve the issue quickly. What is their process like for dealing with minor issues? How do they handle technical problems? What about user errors? How often will they send someone to you? Is it easy to resolve basic issues online?

Some of this comes down to your vendor’s culture. But it has to do with their capacity, too. You and your employees will need to interact with them regularly, so be sure to look into what that process looks like.

4. Extensive expertise

While many industries have some sort of web-portal system, health plan portals are a unique niche. You don’t just want a vendor with years of experience building web-based tools. They need to have an intimate understanding of the healthcare system, cybersecurity, HIPAA, and the other compliance standards that apply to your plans. They should also be familiar with how your organization uses the tools, data, and processes you rely on every day.

Your members’ personal information is too valuable to put in the hands of a company that doesn’t understand how you need to use it and how it’s vulnerable online. And a health plan portal is too integral to your organization to entrust to a vendor that doesn’t have extensive experience with the nuances of delivering healthcare.

How do you best engage members and providers so that they want to use your portal vs. calling the call center? Is the portal built with industry best practices to ensure a positive user experience that makes the user want to come back and use it again? Does the vendor help with communication plans and strategies to communicate with users (members and providers) so that they know the tool exists? These are all questions that focus on a major theme that many forget in this process. Asking that your vendor not only be good at building the solution, but also experts at understanding and implementing best practices for engagement and adoption of your portal is essential.

5. Seamless integration

A well-integrated portal system can streamline your entire healthcare delivery system. Unfortunately, many portals wind up being little more than a communication channel. gets complicated fast when you want to present more data in meaningful ways.

One of the reasons some health plans choose to build their own portal is because they can’t find a vendor portal system that already integrates with the tools they currently use. It’s a big red flag if a vendor can’t integrate with your tools. But keep in mind: just because a vendor doesn’t already integrate with them doesn’t mean they can’t.

Many vendors have a lot of experience working with a wide range of tools because so many of their clients use different systems. As a vendor integrates their platform with more tools, they get faster at creating new integrations, and the integrations they implement become smoother.

Ideally, you want to find a vendor that can sync the information from all of your tools into a single intuitive dashboard—for your members, your staff, and your providers.

This is why it’s important to get a demo of a vendor’s portal system, so you can see how those integrations come into play. Your vendor needs to understand what information the portal needs to display and where that data comes from.

Not sure if you should build or buy your health portal?

Every health plan has to navigate this process for themselves. Your organization’s unique circumstances will determine what you need from a vendor and how doable it is to build your own portal system. Whether you build or buy, your health portal is a big investment, and your choice will have a huge impact on the future of your organization and the quality of your members’ care.

In our next ebook, you’ll find questions every health plan needs to explore when making this important decision.

Stay tuned in January to check out our ebook answering a vital question – Should You DIY Your Health Plan Portal?