This market for BPO and BPaaS is “poised to pop”
A year ago, we took our first look at population health and care management business process outsourcing trends and service providers. This year’s update considers the increased focus and impact on health, medical, and administrative outcomes through BPO and BPaaS engagements. We cover the availability of skilled resources, increasingly intelligent automation, analytics, and improvements to and bundling with componentized, cloud-based platforms. It’s quite a list, and there are pockets of momentum that hold promise for delivering more effective healthcare operations for these changing times.
At the Heart of Healthcare
The healthcare industry is looking to put the people, their lifetime and lifestyle, at the heart of the business in order to drive better health and care experience at a lower cost. And healthcare organizations—payers, providers, and others in the ecosystem—are challenged to deliver on this set of outcomes, and bridge the old legacy world to the new As-a-Service Economy. As people take on more responsibility for their own health and care, they want quality, accessibility, and affordability. And every part of a healthcare operation—front, middle, and back office—has a role to play to make it a more “intelligent operation,” one that is consumer focused and results oriented.
A number of service providers are stepping in to help change the game, and partner to make healthcare business operations more effective, with an eye toward impacting these health, medical, and financial outcomes. We hear from service buyers that they are partnering increasingly for resources—to allow local clinicians more time and energy for interactions with healthcare consumers by rethinking what activity can be done remotely, through partners, or even automated.
In this blueprint, we take a look at the role of service providers in bringing together talent and technology to broker solutions through BPO and BPaaS engagements. The scope is:
- Population Data Management and Analytics: identifying whom to target with what intervention
- Consumer Engagement and Interaction: reaching out, engaging healthcare consumers
- Utilization Management: processing authorizations, reviews, appeals and grievances
- Care Coordination: coordinating care activity
- Performance Management and Operational Analytics: program evaluation and assessment, quality and compliance reporting
Service Provider Landscape and Blueprint Grid Performance
As-a-Service Winners are service providers that are in collaborative engagements with clients, and making recognizable investments in future capabilities in talent and technology. These providers are also leading in incorporating analytics and BPaaS to deliver insight driven services:
- Accenture: Sophisticated and innovative thought leader with a wealth of knowledge and experience looking to “change the game” in healthcare operations
- Cognizant: Partnering and driving results with an increasing portfolio of BPaaS for population health and care management support
- EXL: An operations management and analytics company that partners with the option of platform based and BPaaS services
- Xerox: Coming out strong with refreshed focus on research-based population health that taps into healthcare heritage and recent acquisitions
The High Performers all execute well, are investing in future capabilities, but need to gain more consistency and traction among clients in defining and delivering against business outcomes, and using analytics in on-going services:
- HGS: Building out a nicely comprehensive capability for enabling “healthy behaviors” and interactions between consumers, payers, and healthcare providers
- Sutherland Global Services: Willing to align and invest in resources to partner with clients, creating a strong data-based starting point
- Wipro: Using customer experience journey maps as a basis for helping healthcare address industry disruptions and drive outcomes
A new addition to the Blueprint this year, HCCA Health Connections (although not new to the industry) is a solid Execution Powerhouse with energetic, high quality clinical process outsourcing.
Dell has High Potential for increasing momentum for BPO/BPaaS for analytics and unique IP around imaging, social, and telehealth, and a strong ecosystem.
HCL shows innovation in enabling healthcare management through digital channels—mobility and telehealth—for the life sciences that could be used more in healthcare as well.
Picking up the Pace—What’s On the Horizon for Population Health and Care Management Operations?
In the year since the inaugural HfS Population Health and Care Management Blueprint, we have seen an increase in the use of automation, analytics, and software platforms, attention to talent development, expansion in the location of resources, and blending of talent and technology.
But the pace is slower than it could or should be, due to continued concerns about data privacy and security, locked legacy contracts, and “old habits that die hard” in procurement. Compliance both hinders and helps progress, with constant updates and requirements from the government, but also promotions and clarifications that are meant to increase interoperability, transparency, data access, and quality health care. We have to choose and commit to doing something in a different way to get a different result.
In Healthcare, more so than in other industries, service buyers are increasingly ready to switch out service providers that fail to help them evolve to a more flexible, automated, and insight driven operation. In our recent research, 66% of healthcare executive buyers—higher than any other industry—said they would likely look around when their contracts come up renewal. There is just so much at stake in the Healthcare industry now, between the driving forces of consumerism and compliance.
This side of the Healthcare Business Process Services Market—BPO and BPaaS addressing health and care management—is “poised to pop.” We have seen acquisitions and investments to get a handle on structured and unstructured data, change the mix in the workforce towards more use of automation and greater healthcare and analytics expertise, and momentum with one-to-many models and applications. We look forward to seeing how healthcare executives can partner with service providers to reinvent not just healthcare, but healthcare operations, and truly impact the health and care of consumers, driving toward higher quality, accessibility, and affordability.
The HfS 2016 Population Health and Care Management Blueprint covers market trends and direction as well as the analysis of 10 service providers: Accenture, Cognizant, Dell, EXL, HCCA Health Connections, HCL, Hinduja Global Services (HGS), Sutherland Global Services, Wipro, and Xerox. For more detail—including visuals of the market and contract activity and analyses of the service providers—click here to access and download the Blueprint.