Vendor Analysis
published on Aug 21, 2019
Report Overview:
NelsonHall estimates that this practice generated approximately $39m in revenue in 2018 from commercial clients. Healthcare payer BPS capabilities lie within Capgemini's Managed Services division.
Who is this Report for:
NelsonHall’s profile of Capgemini’s Healthcare Payer Business Process Services (BPS) is a comprehensive assessment of service offerings and capabilities designed for:
- Sourcing managers monitoring the capabilities of existing suppliers to deliver business process services to healthcare payers
- Vendor marketing, sales and business managers looking to benchmark themselves against their peers
- Financial analysts and investors specializing in the support services sector.
Scope of this Report:
The report provides a comprehensive and objective analysis of Capgemini’s offerings, capabilities, and market presence in support of business process transformation through the application of healthcare payer BPS including the company’s:
- Offerings and key service components
- Delivery organization
- Customer base, including the company’s targeting strategy and examples of current contracts (where available)
- Revenue estimates for healthcare payer BPS
- Strategy, emphasis and new developments in support of healthcare payer BPS
- Strengths, weaknesses and outlook.
Key Findings & Highlights:
NelsonHall estimates that this practice generated approximately $39m in revenue in 2018 from commercial clients. Healthcare payer BPS capabilities lie within Capgemini's Managed Services division.
NelsonHall estimates that Capgemini’s payer BPS practice has approximately 2,000 personnel in service of its health insurance business. Many of these personnel may serve clients in horizontally-oriented offerings (e.g. FAO, HRO) and many may support insurance carriers that predominantly do business in P&C and L&A businesses but work with Capgemini to offer supplemental healthcare products.
Distinctive elements of Capgemini’s payer BPS practice:
In the U.S. Capgemini’s strengths with commercial BPS clients lie in mailroom and claims processing capabilities for supplemental products, such as Medicare Advantage. Capgemini has a long history supporting clients in MA.
- In March 2018 Capgemini acquired privately-owned LiquidHub for €400m. This IT services acquisition included a small healthcare payer business with some longterm BPS contracts focused on
- Member and patient experience
- Reimbursement and revenue enhancement
- Analytics.
- Areas in which Capgemini offers particular expertise for healthcare payers include supplemental lines of business. This expertise includes:
- Medicare Advantage
- Medicare Supplement
- Medicare Part D
- Long term care
- Critical illness
- Dental and vision
- Claims administration
- Capgemini operates as a third party administrator and as an outsourcing vendor for health insurance carriers in several functions, and supports horizontal offerings for these clients in FAO, HRO and analytics.