6 Essential Steps for Mainframe Modernization in Healthcare

Update your healthcare system with the latest technologies to keep patient information secure and improve the quality of care.

Dec. 9, 2025 | By Adam Streets

As health insurers face mounting pressure to deliver seamless digital experiences, legacy mainframe systems—once the gold standard for reliability—are increasingly viewed as barriers to agility, scalability and innovation. The shift away from mainframes is no longer an ambitious goal; it’s often a strategic imperative. Aligning business value to a company’s bottom line and return on investment (ROI) remains a key strategic focus in executive discussions.

The Business Value of Healthcare Modernization

Benefits to updating your healthcare system include:

• Reduced claims processing time
• Higher first-pass rates (percentage of claims that are paid or transferred to patient responsibility on the first submission, without errors or rejections)
• Faster time to market

Here are six actions you can take to transform and modernize.

1. Conduct a Comprehensive Mainframe Ecosystem Assessment

Begin with a granular assessment of your application landscape. Identify not only which systems rely on the mainframe but also how tightly coupled they are to business-critical workflows like claims adjudication, member services and compliance reporting.

In one use case, 15-plus mainframe-based applications were found intertwined with close to 400 distributed systems in their ecosystem, revealing hidden dependencies that shaped their migration strategy.

2. Develop a Phased Mainframe Migration Roadmap

Successful migration and transition demand more than technical sequencing. They require alignment with business cycles, staffing realities and regulatory timelines. Concerns include rising licensing and operational costs, technical debt, manual workflows, duplicate data, and a retiring mainframe workforce.

A comprehensive roadmap could outline phased deliverables across areas such as application modernization, data migration, queue messaging, replatforming and test automation.

3. Upskill Your Team and Adopt Modern Development Practices

Modernization is about not just new tools and technologies but also new mindsets. Invest in targeted enablement programs that move from legacy COBOL expertise to modern skills such as Java development and industry best practices. Teams could apply this by adopting Agile practices, automated CI/CD pipelines and microservices architectures to accelerate release velocity and reduce manual bottlenecks.

4. Migrate to Cloud-Native and Modernized Architectures

Modernized platforms offer elasticity and resilience that mainframes can’t match. This could mean you consider migrating outdated legacy workloads to Linux, implementing dashboards for observability and using Python-based QA automation to streamline testing.

These moves help reduce technical debt and position the organization for future agility and innovation.

5. Embed Security and Healthcare Compliance Throughout Migration

Security should be embedded, not bolted on at the end. Gaps in DevSecOps can be addressed, for example, by automating release gates and improving cyber-resilience postures. Additionally, modernization efforts need to include robust data governance to ensure regulatory compliance across migrated systems.

6. Track Key Modernization Metrics and ROI

Mainframe modernization is a means to an end. Track outcomes like cost reduction, faster claims processing speed and infrastructure run rate savings as byproducts of retiring the mainframe.

Strategic Mainframe Modernization: Your Path Forward

In short, mainframe decommissioning isn’t just a technical upgrade. It’s a strategic pivot that can unlock operational agility, reduce long-term licensing and operational costs, streamline workflows, and reduce risks.

By anchoring a modernization strategy in real-world learnings and industry best practices, health insurers can turn complexity into competitive advantage.