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for Healthcare Payer

Track the pattern of service adoption by monitoring Healthcare Payer contract awards by your peers. Identify who are the successful vendors this industry now. Updated monthly!

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Healthcare Payer Operations Transformation

Customer Perspectives

by Bilal Chaudhry

published on Feb 01, 2024

Access to this report is restricted to logged in clients with access. Login to get full access

Report Overview:

This report is for end-user (buy-side) organizations who are interested in understanding the current and future shape of the healthcare payer operations transformation market as well as the requirements and experiences of their peers.

Key Findings & Highlights:

NelsonHall’s Healthcare Payer Operations Transformation report focuses on how healthcare payer service providers leverage new technologies such as analytics, intelligent automation, and generative AI to transform healthcare payer operating models and achieve member satisfaction while reducing operational costs.

This major NelsonHall study is essential reading for COOs within major healthcare payer/plans as our in-depth analysis will inform them of what they can achieve now, and what they can expect to achieve over the next few years. For buyers of healthcare payer operations transformation and BPS services, the project will identify the following: 

• The operational issues and requirements of their peers and how the demand profile is changing
• How vendors are addressing buyer requirements with their current offerings
• The range of benefits being achieved by their peers with case study examples
• How vendor capability and the art of possible are evolving, and what to look for in a next-generation service, including:
• Streamline claims processing
• Data analytics for informed decision making
• Enhancement in member engagement
• Interoperability and integration
• Provider data/network management, including provider credentialing
• Individual vendor strengths and capabilities
• The success factors to look for when selecting a potential vendor partner.

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