Business process services (BPS) was once the gold standard for healthcare payer operations. Its transaction-based pricing worked well to lower labor costs. Although BPS is still a viable option for cost savings, payers need more than just labor arbitrage to compete in today’s rapidly evolving healthcare market; they also need to adapt to value-based care models, improve membership outcomes and experiences, and find new sources of revenue. None of this is possible with outdated, rigid technologies.
Enter business process-as-a-service (BPaaS). BPaaS is a platform-based administrative solution that provides operational agility and efficiency by combining expert people, proven processes and cutting-edge technology to not only lower costs but also improve flexibility, efficiency and effectiveness. With BPaaS, the service provider not only takes full responsibility for the platform-based solution — including keeping the system current with updates, upgrades, maintenance and security — but also provides a long-term strategy to deliver business outcomes in the form of member benefits and revenue growth. The system can scale up or down according to payer needs, and costs are based on a per-member-per-month model.