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[...]
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[...]
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[...]
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[...]
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[...]