featured posts:
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WNS’ Healthcare Consult: Enhancing Clinical Guidance & Authorization Support Services
Aug 16, 2024, by Bilal ChaudhryIn recent discussions with WNS, NelsonHall explored the company's advanced healthcare management solutions. WNS provides evidence-based criteria to guide providers in ordering the most appropriate tests, procedures, and treatments for their members. This approach enhances patient care delivery and outcomes while improving provider relations and reducing healthcare treat[...]
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DXC Enhances P&C Insurance Solutions with AI-Now Strategy
Apr 08, 2024, by Bilal ChaudhryNelsonHall recently attended the DXC Connect Insurance Executive Forum in Charleston, South Carolina, where the theme was ‘Connecting the world’s largest insurance community to solve challenges and drive value’. DXC focused on: Its new product strategy to meet insurers’ transformation and investment needs The ability to combine its SaaS solutions with [...]
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Price Transparency in Healthcare Payer BPS Market: Capgemini Spotlight
Aug 02, 2021, by NelsonHall AnalystIn 2020, the U.S. healthcare payer BPS market saw accelerated growth in the adoption and design of digital solutions across all functional areas. The acceleration is driven mainly by consumer demand for an "Amazon" experience from their health plans and providers, to know the cost of care for associated benefit plans to assist in plan selection or inform decisions about ele[...]
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WNS Aggressively Developing Digital Interventions to Transform Insurers’ Claims Capability
Jan 22, 2021, by John WillmottWNS has a highly developed property & casualty (P&C) insurance practice handling 30 million claims transactions and ~$12 billion in claims spend annually. The company has extensive capability in property & casualty supporting motor, property, casualty, employer and public liability for insurers, fleet operators, MGAs, global corporates, and municipal authorities. WNS has [...]
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COVID-19: Driving a New Normal for Healthcare, A Cognizant POV
Oct 13, 2020, by NelsonHall AnalystDigital front doors and transparency a new normal for healthcare? U.S. healthcare is no stranger to an environment of continuous change and has not been spared the effects of the COVID-19 global pandemic in 2020. The unique circumstances born from the need for social distancing during the pandemic have accelerated healthcare consumers' demands for digital transformation. The ask comes f[...]
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35% of Insurance Carriers Will Adopt AI Across Multiple Use Cases by 2022
Apr 06, 2020, by NelsonHall AnalystNelsonHall predicts that by 2022, 35% of insurance industry carriers will be in the process of adopting AI technology across multiple use cases within the enterprise. This is based on NelsonHall survey data from the insurance industry that tracks adoption of both RPA and AI (NLP/ML/DL) technology across the property & casualty, health insurance, and life & annuities insurance[...]
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Infosys Showcases Resiliency of Nearshore Outsourcing Services in Face of Natural Disasters
Jan 23, 2020, by NelsonHall AnalystA magnitude-6.4 earthquake struck Puerto Rico on January 6, killing one person, toppling homes and buildings, and triggering a blackout on the island that is still recovering two years after Hurricane Maria. Governor Wanda Vázquez declared a state of emergency and activated the Puerto Rico National Guard to help with recovery efforts. How might this earthquake disaster have[...]
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Insurance Start-Up Convex Group Contracts with WNS to Target Cost Ratio of 10%-11%
Dec 04, 2019, by NelsonHall AnalystConvex Group is a start-up specialty insurer and reinsurer focused on complex risks, launched with $1.8bn of committed capital in April 2019. Convex will underwrite insurance and reinsurance for “complex specialty risks across a diversified range of business lines” in London and Bermuda. The company aims to adopt a conservative investment strategy with a predominantly hig[...]
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WNS’ Healthcare Business & Approach to Transformation
Jun 03, 2019, by NelsonHall AnalystDozens 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[...]
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How NTT DATA Established Enterprise Automation Governance for BCBS Health Insurance Carrier
Apr 29, 2019, by NelsonHall AnalystIn 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[...]
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The Case for Expanding Provider Network Coopetition Among U.S. Health Plans
Apr 18, 2019, by NelsonHall AnalystIn 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[...]
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Benefitfocus: Strategy Shift & Other Key Updates
Apr 11, 2019, by NelsonHall AnalystBenefitfocus, 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[...]
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How Sutherland Facilitated Coopetition Among California Health Plans
Mar 29, 2019, by NelsonHall AnalystIn 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[...]
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CX, RCM & Other Key Takeaways from HIMSS19
Feb 26, 2019, by NelsonHall AnalystNelsonHall 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[...]
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RPA in Revenue Cycle Management: 3 Lessons Learned by Access Healthcare
Feb 21, 2019, by NelsonHall AnalystThe 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[...]
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Rising U.S. Healthcare Costs: Time to Address the Root Causes
Dec 13, 2018, by NelsonHall AnalystThe 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[...]
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Atos to Leverage New Aegon Contract to Challenge for U.K. Life & Pensions Closed Books
Nov 30, 2018, by John WillmottIn 2016, Atos was awarded a 13-year life & pensions BPO contract by Aegon, taking over from the incumbent Serco and involving the transfer of ~300 people in a center in Lytham St Annes. The services provided by Atos within this contract include managing end-to-end operations, from initial underwriting through to claims processing, for Aegon's individual protection offering[...]
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U.S. RCM Outsourcing Services Market Ripe for Consolidation
Sep 21, 2018, by NelsonHall AnalystThe 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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SE2’s Digital Transformation: Enabling Future-Proof Life Insurance & Annuities
Oct 19, 2017, by NelsonHall AnalystNelsonHall recently attended the SE2 Partnership Forum, entitled ‘Future-proof: From Here to Digital’, in Washington D.C., where the main focal point of discussion was the challenge of digital transformation in the life insurance and annuity sector. Here I look at a number of developments in SE2’s offerings that are helping clients to address the challenge of dig[...]
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Genpact: Using OnSource to Bring New Digital Process Models to Property Claims Assessments
Aug 31, 2017, by Rachael StormonthNelsonHall recently caught up with Genpact to discuss their recent acquisition of OnSource and their plans to integrate it with BrightClaim – we were not surprised to hear that the two acquisitions are indeed connected, and part of Genpact’s strategy to introduce new digital process models in P&C insurance. To set the scene: Earlier this month, on the day of [...]
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Genpact Acquires BrightClaim to Enhance Positioning as Disruptive Claims Managed Service Provider
May 18, 2017, by Rachael StormonthGenpact has had a traditional presence in offshore-based adjudication support services for the property & casualty sector but is now, supported by its acquisition of BrightClaim, aiming to reposition as a disruptive provider of claims managed services. The acquisition of BrightClaim provides Genpact with deep onshore domain and loss adjusting capability, which Genpact is looki[...]
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RPA Operating Model Guidelines, Part 3: From Pilot to Production & Beyond – The Keys to Successful RPA Deployment
Nov 09, 2016, by John WillmottAs well as conducting extensive research into RPA and AI, NelsonHall is also chairing international conferences on the subject. In July, we chaired SSON’s second RPA in Shared Services Summit in Chicago, and we will also be chairing SSON’s third RPA in Shared Services Summit in Braselton, Georgia on 1st to 2nd December. In the build-up to the December event we thought we would shar[...]
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WNS Acquires HealthHelp with a View to Doubling its Healthcare Revenues
Mar 30, 2017, by Rachael StormonthOn March 15, WNS announced its intended acquisition of HealthHelp, in what, at $95m, will be its largest acquisition to date. HealthHelp, founded in 1999 and headquartered in Houston, TX is a 400-FTE strong healthcare utilization management specialist. In many ways, the HealthHelp acquisition has much in common with WNS’ Value Edge acquisition. HealthHelp, like Value Edge, will become[...]
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NIIT Technologies: Two New EVPs to Drive Digital & Platform Strategies
Mar 28, 2017, by Mike SmartNelsonHall recently attended NIIT Technologies European Analyst & Advisor Forum in London. For those readers not familiar with the company, NIIT Technologies is a mid-sized Indian-headquartered services provider, generating annual revenues of ~$410m, of which around 48% from the U.S. and a third from EMEA. EMEA has dominated recent wins (50% of the order intake in the last quarter), and the co[...]
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Insurance BPS: Delivery & Service Line Trends for 2017
Feb 09, 2017, by NelsonHall AnalystThe insurance outsourcing industry is moving at a fast pace in response to the need for rapid deployment of digital platforms and offerings, as well as advancements in new distribution models that are emerging via ‘insurtech’ start-ups. Here I take a look at some of the key trends driving the insurance BPS market in 2017, both in terms of delivery and transformation, and [...]