Health insurers across the U.S. are in a battle to boost revenues and grow membership by offering new member-focused products and services. Although there’s plenty of growth opportunity, however, many health plans are unable to capitalize on it due to outdated technology. As outlined in the first part of this series, business process as-a-service (BPaaS) can help neutralize these challenges by introducing digital technologies into the health plan’s operations.
BPaaS is a platform-based administrative solution that provides operational agility and efficiency by combining expert people, proven processes and cutting-edge technology, allowing health plan staff to focus on more complex endeavors and strategic work that improves the member experience.
For instance, staff who traditionally would be assigned to administrative processes are free to focus on such things as:
- Benefit design and structure (i.e., adding enhancements to the benefits package).
- Incentive programs and new lines of business (i.e., Silver Sneakers and medical transportation).
- Avoidable injuries (i.e., teach seniors how to avoid physical injuries).
- Marketing initiatives to identify potential members and retain existing members, which naturally leads to increased revenue.
Although healthcare payers know they need to do these things, they often don’t have the resources to adequately focus on such initiatives, or they pursue each item individually rather than as a holistic program. Because BPaaS helps free up resources, it provides needed additional bandwidth.
Expanding Brand Exposure
Boosting the membership experience can also directly impact the health plan’s Star Rating, which is a Medicare point system that rates how well Medicare Advantage and Part D plans perform across five categories. Three of these categories are directly related to the member experience: plan responsiveness, member complaints, and attrition and health plan customer service. Ratings range from one to five stars, and dropping below three stars for three years in a row flags the plan as low-performing.