The healthcare industry is going through a paradigm shift to a member-centric, outcome-based model while adhering to the new regulatory and financial frameworks. This shift has created a need for more robust IT systems to enable digital transformation.
The accelerated shift towards a new digital experience, data interoperability, and overall stakeholder engagement enables the payers to uncover novel opportunities. Through increased collaboration, proactive sharing of patient data, and delivering highly engaging experiences, payers can capture member mind share and increase member retention.
We’re working with leading health plans to help them combine innovative digital solutions and data-driven insights with trend-setting stakeholder collaboration to achieve the quadruple aim – reduce the cost of care, achieve better outcomes, enhance member satisfaction, and improve healthcare professional experience.
Our Solutions for Healthcare Payers
We offer a comprehensive suite of solutions tailored for healthcare payers, aimed at addressing their unique challenges. Our services include leveraging cutting-edge technology to reduce healthcare costs, enhancing member satisfaction through improved customer experiences, and ensuring regulatory compliance to minimize risks.
Reduce cost of healthcare through technology acceleration
Rising cost of healthcare and consequently medical loss ratio is leading to significant margin pressure for health plans translating into higher premium for members.
Tap into our digital offerings curated specifically to optimize cost of administration and clinical care that leverage data science and AI driven solutions built on digital first, cloud foundations.
Improve your customer experiences
The health insurance industry has witnessed one of the lowest Net Promoter Scores (NPS) due to lack of transparency, personalization and sophisticated digital capabilities.
Drive unparalleled customer experiences by leveraging automation and cutting-edge technologies to facilitate seamless collaboration and coordination. Our solutions address the 360-degree needs of members, providers, employers and brokers.
Maintain regulatory compliance
Many health plans struggle with remaining compliant to regulatory requirements and responding to new regulations in a timely manner due to archaic legacy systems and security controls.
Implement robust data security measures and electronic recordkeeping systems that align with industry standards and privacy regulations. We can help you leverage AI-powered tools to conduct audits, analyze claims data and monitor transactions, facilitating proactive identification of compliance issues and timely corrective actions.
Manage commercial, Medicare and Medicaid markets
Every health system has different requirements that are often not compatible with a single solution.
Manage IT platforms for health plans across commercial, Medicare and Medicaid (MMIS) domains through strategic digital adoption.
Improve health outcome with integrated care experience
Care fragmentation and lack of real-time data exchange across health ecosystem result in poor engagement and health outcomes for members.
Our healthcare interoperability, value-based care, prior authorization automation and holistic health solutions will help health plans deliver connected health experiences through proactive member engagement, real-time integration and collaboration with providers and plan benefit managers.
Increase accessibility and affordability
The acceptance of virtual care and national scrutiny around equitable care has created demand for services that improve access to care at an affordable cost.
Our digital health solutions for virtual care, remote patient monitoring and home health enable health plans to improve accessibility and convenience for their members. Our health equity, analytics and reporting solutions help health plans lay the foundations for equitable care for their members.
Case Studies
Success Stories from Our Work with Healthcare Payers
Improving cybersecurity posture with HCLTech cybersecurity consulting
HCLTech cybersecurity consulting fortified a leading health conglomerate's cybersecurity with a tailored solution, ensuring robust defense and operational continuity
Navigating healthcare operations with data-enabled transformative insights
Unveiling Informatica’s dominance: Inside the operations of America’s largest managed healthcare consortium
Streamlining data handling and driving informed decision making
Overcoming legacy system challenges and empowering productivity with Alteryx
Accelerated Network Transformation Journey
For a Leading North American health insurer
Awards and Recognitions
HCLTech rated as a Leader in ISG Provider Lens™ - Healthcare Digital Services, U.S. 2023
HCLTech rated as a Leader in ISG Provider Lens™ - Payer Digital Transformation Services, U.S. 2023
HCL Technologies rated as a Star Performer & Leader in Everest Group Healthcare Payer Digital Services Peak Matrix® Assessment 2022
Trends and Insights
Ready for AI in Healthcare: Evolving beyond hype to enterprise Scale AI
The healthcare industry is constantly evolving, influenced by transformative technologies like GenAI, promising more efficient and effective solutions to healthcare problems.
What is artificial intelligence (AI) in healthcare?
The application of AI in healthcare has resulted in a number of tangible benefits, including early disease detection, faster and more accurate analysis of medical images, robotic surgery, accelerated drug discovery, and more.
The impact of generative AI in healthcare: Revolutionizing patient care
The advent of generative AI is leading to the transformation of healthcare and especially, the hyper-personalization of patient care
How Total Experience can transform healthcare businesses
The cure for the healthcare distrust epidemic is collaboration. Total Experience connects stakeholders, improves care and rebuilds trust
Super Agents' for elevated customer experience
In today's digital era, inefficient contact center agent systems and platforms have emerged as the primary obstacle to driving customer engagement.
Revolutionize member enrollment with a next-gen platform
Boost customer experience and loyalty
Powering healthcare with 5G
Examining the importance and benefits of 5G in healthcare
Meet Our Ecosystem Partners
