Dive Brief:
- US healthcare payers (particularly new plans and provider-based payer organizations) are increasingly utilizing business process outsourcing (BPO) strategies in unconventional ways to help reduce operating costs, according to a Black Book survey.
- The market for traditional payer BPO services (such as claims adjudication, call centers and member processing) only saw modest growth following the addition of 7.2 million new healthcare enrollees through the Affordable Care Act.
- Now, the most popular BPO functions include outsourcing analytics, new plan set up, claims modernization, alternative payment services, utilization management, security, value-based solutions development, sales and marketing, population health and big data initiatives, and multi-channel contact center management, the survey finds.
Dive Insight:
"Payer contracting in these evolving areas has nearly doubled in just the past twelve months," notes Doug Brown, managing partner of Black Book.
One standout statistic: 74% of health plan managers said they would likely outsource the development and management of new value-based payment models because of "inadequate technology, staffing, resources or competing IT ventures currently underway."
The survey concluded that the large increases in outsourcing were attributable in large part to the 39% of small-to-medium sized plans that are now contracting for some processes (up from 20% in 2012).
The survey adds that eight of 10 of the largest US health payers currently outsource major portions of their operations.