Case study

The challenge

Parkland Community Health Plan (PCHP) needed to improve how it meets the growing needs of its medically underserved populations in North Texas. It sought to digitize its information technology platform to better manage health data, member transactions and the physicians and hospitals in its network. PCHP wanted to transition from outsourced administration to remedy declining membership and gain better reporting. As nearly all its operations were outsourced, there was little visibility into areas that needed improvement. Cognizant responded to the managed care organization’s request for proposal, recommending the long-term benefits of TriZetto® QNXT™ as a platform, and was chosen for the transformation engagement.

Our approach

Cognizant introduced the TriZetto® QNXT™ core administration platform, leveraging a business process as a service (BPaaS) model to include enrollment, claims, customer service and regulatory reporting modules. The platform delivers all care management, member services, provider relations and quality and data analytics. Thanks to the BPaaS model, PCHP avoided the purchase of new technology and gained the flexibility and scalability needed to carry out its long-term growth plans. The transition was smooth and compliant with virtually no disruption to member services or operations. Thanks to the new system, PCHP has increased productivity and lowered core system costs.

Greater visibility, improved experiences

Now, with fully integrated member touchpoints, PCHP effectively coordinates all administrative and clinical aspects of its member experience. The system’s capabilities offer the provider’s teams more control over members’ experiences. New analytics options give PCHP insight into how to effectively engage members while putting the plan provider in a much better position to coordinate care and enhance members’ experiences across their healthcare needs. Unlike previously outsourced systems, the QNXT™ BPaaS core administration solution allows PCHP to put members at the center of the system and increase accountability. The solution also serves as the foundation for future expansion opportunities.

Enhanced

productivity since the QNXT™ BPaaS platform has gone live

Decreased

core system costs from previous year’s costs

Compliant

transition in a virtual environment