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Innovation Beyond The Four Walls



January, 27, 2016

Cognizant Acquires KBACE Technologies to Enable Clients to Accelerate Journey to Cloud and Improve Business Agility


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Consulting & Solutions

Engage with our business and technology experts for strategic solutions that address the full scope of healthcare issues today, from compliance through integrated health management.
Solutions Spotlight
Cognizant’s Healthcare Business Consulting services address the industry trends and market forces that are driving business and IT spend—from rethinking new business models to optimizing operations and enabling technology innovation.
Deliver consumer‑centric care leveraging digital communications
Cognizant offers solutions specific to the challenges of Healthcare organizations. Browse the pages below to
learn more.


Agile And Lean Transformation: Creating a Foundation for Success
For communications services providers (CSPs), the transformational journey to Agile and Lean methodologies is best accomplished with a focus on four key spheres: individual behavior, institutionalizing change management, team roles and managing governance.
Leveraging Anonymized Patient Level Data to Detect Hidden Market Potential
Longitudinal analysis of anonymized patient level data (APLD) is a powerful tool for assessing patient experience on a granular level that will lead to better treatment outcomes and increased life sciences market penetration.
The Affordable Care Act and Its Impact on Workers’ Compensation
While the Affordable Care Act (ACA) is expected to reduce the number of uninsured and improve personal wellness in the U.S., the law's changes in workforce definitions will significantly impact workforce dynamics, employee hiring, employers' benefits strategies and wellness programs—requiring a reevaluation of how workers' compensation is accounted for and delivered.
Identifying Key Opinion Leaders Using Social Network Analysis
In the pharmaceuticals industry, locating key opinion leaders (KOLs) is essential—and very difficult—for clinical trials and other assessments. We provide a method and an in‑depth example, of using social network analysis (SNA) to identify these critical players.
Enterprise Risk Management: Minimizing Exposure, Fostering Innovation and Accelerating Growth
Formal policies and processes for enterprise risk management (ERM) are common among large corporations, such as those in finance and healthcare. However, most technology‑focused companies consider ERM an obstacle to innovation. When properly implemented and maintained, an enterprise risk management program can lessen risk, accelerate strategic development, drive innovation and bolster bottom‑line growth.
Making Life Easier for Investigators: A Shared Solution for Smarter, Faster Clinical Trials
The industry's Shared Investigator Platform significantly reduces the time and cost of clinical trials, simplifying work for investigators and bringing promising therapies to market more quickly.
The Rise of the Smart Product Economy
Making products smart can deliver game‑changing innovation, enriched customer experiences and new, across‑the‑board levels of efficiency. Our latest research reveals practical steps business leaders can take to benefit from this quickly intensifying and accelerating trend.
Real‑World Evidence: A Better Life Journey for Pharmas, Payers and Patients
Driven partly by regulatory pressure, stakeholders in the healthcare ecosystem—including payers and patients—now want real-world evidence (RWE) about wellness to supplement and expand randomized control trial (RCT) input from pharmas about pharmaceuticals' efficacy and effectiveness.
Using Advanced Analytics, Drug Makers Reach Decision-Makers More Effectively
By analyzing digital footprints, pharma companies can better identify key influencers throughout their integrated delivery networks.
How Pharma Can Fully Digitize Interactions with Healthcare Professionals
By building end-to-end IT ecosystems and understanding preferred communications channels, pharmaceuticals companies can create more engaging and fruitful digital relationships with healthcare professionals.


  • A Leading Blues Plan Prepares for Healthcare Insurance Exchange
  • A Leading Health System Prepares for ACO Marketplace
  • A Leading Payer Reduces the Costs of Medical Management
  • A Leading Hospital Addresses the Impacts of ICD-10

A Leading Blues Plan Prepares for the Healthcare Insurance Exchange

A leading blues plan was preparing for Health Insurance Exchange (HIX) participation in several states and on the federal exchange. Cognizant was engaged to assist with organization change management and contingency planning efforts.

A centralized PMO was established to manage HIX functional projects and provide ongoing advisory services including:

  • Monitoring and managing the governance controls and implementation activities associated with the different exchanges across state-based and federal HIXs.
  • Establishing a risk and QA function to actively track and seek resolution of project—and program—level risk and issues.
  • Established a comprehensive roadmap for exchange readiness and integration.
  • Increased effectiveness in managing care for risk-based contracts reduced duplication of effort across solution, process and plan development.

A Leading Health System Prepares for the ACO Marketplace

To compete in the emerging ACO marketplace, a leading health system comprised of multiple hospitals, research centers and thousands of providers had begun to make risk-based contracts, pilot population-based care delivery programs and planning for exchange products. Cognizant and the health system partnered to determine a technology and business strategy including:

  • A current state assessment to understand existing risk-based contracts and accountable care-based pilot impacts, evaluating gaps across people, process and technology.
  • Gathering business requirements to integrate and support care management needs across the enterprise.
  • Developing the business and conceptual technical architecture to support required ACO care management capabilities.
  • An integrated care management roadmap to ensure alignment of technical and business initiatives.
  • Created a holistic view of accountable care impacts to business processes and IT systems.
  • Established a common plan for managing ACO initiatives for IT and business leadership.
  • Aligned technology issues with priority business requirements to accelerate implementation, close operational gaps and reduce duplication of effort.

A Leading Payer Reduces the Costs of Medical Management

A national health insurance plan with more than 30 million members across the U.S. was under a corporate mandate to reduce medical management costs within the next fiscal year. The health plan’s clinical talent hiring and retention costs were high and it also faced considerable challenges in staffing for care management. The health plan needed a comprehensive strategy for addressing MLR regulations and compliance.

Cognizant developed a complete solution for handling the client’s commercial utilization management (UM) claims from pilot to roll-out. Our accredited and U.S. licensed clinical teams remotely accessed the client’s platform from multiple offshore operations centers and provided a full slate of UM services.

  • Reduced UM labor costs by approximately 48% and increased productivity by 18%.
  • Increased accuracy of intake function from 95% to 98.7%.
  • Increased turnaround compliance from less than 95% to 99.4%.
  • Freed scarce internal clinical resources to mitigate care management staffing challenges.

A Leading Hospital Addresses the Impacts of ICD-10

A leading hospital needed to determine the impact of ICD-10 transformation on their financial outlays; to identify any gaps in their program plan and understand potential risks that could impact overall ICD-10 transition. Cognizant was engaged to conduct an in-depth evaluation of the impact of ICD-10 on corporate finance and revenue cycle management functional areas, including:

  • ICD-10 current state assessment: to understand impact across people, partners, processes and IT; determine readiness of business partners and vendors and identify training needs.
  • Financial Impact Analysis: to evaluate ICD-10 impact by LoB, payers, DRGs and MDCs.
  • Financial Modeling: to identify levers that would have financial impacts due to ICD-10 and enable visibility of impact to cash flows.
  • RCM/Finance-specific implementation plan and risk mitigation strategies.
  • A holistic view of ICD-10 impacts to RCM and finance.
  • Long-term budget planning based on financial impact analysis and sensitivity analysis.
  • View of potential reimbursement losses and gains to aid proactive contract negotiations with payers.
  • Detailed plan of activities, resources and dependencies required to meet the compliance deadline.
  • A Leading Blues Plan Prepares for the Healthcare Insurance Exchange
  • A Leading Health System Prepares for the ACO Marketplace
  • A Leading Payer Reduces the Costs of Medical Management
  • A Leading Hospital Addresses the Impacts of ICD-10

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