The US spends close to US$3.8 trillion on healthcare, which is almost twice as much as what any other major world economy spends, due to the complexities and inefficiencies within the US healthcare system. While inefficiencies plague the entire healthcare ecosystem, payers are the worst affected, with an average operating margin of 4.3%, much lower than a for-profit health system – 6.1%, or a pharma – 19.4%.

This cost pressure, coupled with a fast-changing regulatory landscape and evolving member demands, adds to payers’ woes. With the traditional IT/BPO outsourcing model failing to address these concerns in an effective way, payers are turning their attention toward the innovative Business Process as a Services (BPaaS) outsourcing model, which offers them platform-based modernization. In fact, payers are increasingly realizing the benefits of a BPaaS model over traditional IT/BPO outsourcing models and have been quick to adopt it.

This viewpoint studies the BPaaS model in detail, describes its benefits, and examines current and potential future adoption to achieve the healthcare industry’s objectives.

Scope

Industry: healthcare

Geography: US

Contents

• Make a case for platform-based modernization and the adoption of BPaaS in the healthcare payer market
• Compare the different sourcing models, including shared services, traditional IT/BPO outsourcing, and BPaaS
• Describe the characteristics of a true BPaaS solution and its benefits
• Analyze BPaaS growth trends and adoption in the healthcare payer market
• Describe the best practices for a successful BPaaS deployment

Membership (s)

Healthcare Payer and Provider Business Process

Sourcing and Vendor Management