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Blog posts by Sven Lohse

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  • WNS’ Healthcare Business & Approach to Transformation

    Jun 03, 2019, by Sven Lohse

      Dozens of influencers recently attended the WNS U.S. Influencer Day in New Orleans, where the theme was 'Co-create to Outperform’. Through general overviews of its approaches and through client presentations, the company provided insight into its recent success and its future plans. The backdrop for the conference was cheery, buoyed by 7% annualized growth over the prior fi[...]

  • How NTT DATA Established Enterprise Automation Governance for BCBS Health Insurance Carrier

    Apr 29, 2019, by Sven Lohse

      In this blog, I look at how NTT DATA worked with a large Blue Cross Blue Shield (BCBS) health insurance carrier to establish an enterprise governance structure for automation, and at the lessons learnt along the way. Like many other large BCBS carriers, the company had piloted RPA initiatives, and from the somewhat frustrating results of these experiments, it had formed two conclu[...]

  • The Case for Expanding Provider Network Coopetition Among U.S. Health Plans

    Apr 18, 2019, by Sven Lohse

      In my previous blog, I described how, since 2017, Sutherland has created a shared services model that obviates the need for participating California health plans to separately build and update parallel databases to track the availability of providers of nonurgent care for Medicaid recipients. The company estimates that through its consortium of member health plans it has reduced a[...]

  • Benefitfocus: Strategy Shift & Other Key Updates

    Apr 11, 2019, by Sven Lohse

      Benefitfocus, the cloud-based benefits management platform and services provider, recently hosted 1,200 benefits professionals at their annual One Place conference in Charleston, S.C. The conference featured updates on Benefitfocus’ strategy, enterprise benefits management technology platform, and partners from its ecosystem; and presented an opportunity to learn from[...]

  • How Sutherland Facilitated Coopetition Among California Health Plans

    Mar 29, 2019, by Sven Lohse

      In this blog, I look at how Sutherland tackled the challenge of health plans maintaining accurate provider data in the state of California. The challenge: inaccurate health plan data about providers It’s been difficult for health plans in California to maintain accurate, up-to-date information on the current status of providers in the state. According to outsourcing vendo[...]

  • CX, RCM & Other Key Takeaways from HIMSS19

    Feb 26, 2019, by Sven Lohse

    NelsonHall recently attended HIMSS19 in Orlando, Florida, the largest healthcare IT conference in the world, with over 45K delegates attending and 1.3K vendors in the exhibition. Here are three highlights from the many conversations we had about the state of the healthcare industry. Obstacles to improving CX The conversation about “consumer experience” in healthcare organizat[...]

  • RPA in Revenue Cycle Management: 3 Lessons Learned by Access Healthcare

    Feb 21, 2019, by Sven Lohse

    The healthcare revenue cycle management (RCM) BPS market is becoming technically more advanced as vendors experiment with RPA to drive greater efficiency and productivity, and to improve competitive positioning. Here I look at one such vendor, Access Healthcare, and the lessons they have learned from their own RPA initiatives. Access Healthcare generates ~$145m in revenue delivering RCM BPS[...]

  • Rising U.S. Healthcare Costs: Time to Address the Root Causes

    Dec 13, 2018, by Sven Lohse

      The challenge of rising healthcare costs in the U.S. has been obvious for decades. Or has it? Various interventions have been attempted, but health costs as a percentage of GDP are forecast to continue to climb. National U.S. healthcare expenditure as a percentage of GDP has risen from 17.2% in 2011 to 17.9% in 2017. In February 2018, the U.S. CMS Office of the Actuary estimated t[...]

  • U.S. RCM Outsourcing Services Market Ripe for Consolidation

    Sep 21, 2018, by Sven Lohse

      The healthcare revenue cycle management (RCM) outsourcing services market in the U.S. seems ripe for disruption and consolidation. The macro factors include: Contraction in the number of hospital locations and hospital systems Speedy erosion in the number of small, independent physicians’ practices Increasing complexity in reimbursement models and processes Increasi[...]

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