HfS Research : Can BPOs help “consumerize” health plans?

Health plans are in the throes of figuring out how to more effectively engage with consumers and become B2C businesses.Last week, Hinduja Global Solutions (HGS) made a move to become a partner in this transition by taking a majority stake in Colibrium.

Colibrium was attractive to HGS with more than 30 health plan clients, health insurance experts, a suite of self-service tools and TUO member acquisition & management platform, and existing call center capabilities. HGS and Colibrium have a history of shared clients and this investment will bring Colibrium closely into the HGS infrastructure. HGS will own 89.9% of Colibrium, up from an existing minority stake, and the Colibrium founders will hold the rest.

This matters for the broader health services market because payers are increasingly focused on how to attract, enroll, and keep individuals engaged in their programs through health insurance exchanges, outside of the traditional employer groups. Direct to consumer marketing and sales and broker networks are increasingly common. Colibrium provides a self-service, mobile-enabled health insurance portal and automated workflow to support the insurance purchasing and enrollment process, and also has a group of licensed health insurance agents that know how to respond to consumer needs.

HGS provides BPO support to health payers today by processing enrollments and claims, supporting appeals and enabling other member management activities. The logical extension of these services is to address the new direct to consumer needs including wellness support that can help the healthcare industry to reduce medical costs and increase engagement.

This combination of HGS and Colibrium can create an extended seamless consumer/member lifecycle operation for clients.

The Colibrium TUO suite – on premise and remote options with self-service – includes:

  • TUO Sales and Marketing for campaigns, eligibility verification, underwriting, and enrollment.
  • TUO Service for member management – benefits and claims processing, appeals and grievances, billing, and STARS compliance support.
  • TUO Wellness, with health risk assessments, monitoring data aggregation, alerts and notifications, and community support

    This type of interactive wellness capability in particular is something that payers are tapping into increasingly. Healthcare is evolving to a stage in which proactively helping people manage health is becoming a critical mandate, going beyond the traditional remit of providing care for those who are ill.

    This step is a very logical one for HGS. It fits into the service provider’s sweet spot – enabling smooth, noiseless operations – and extends its ability to support the B2B operation with B2C tools, automated workflow, and experts. HGS’s investment in Colibrium is a show of commitment to payers to help them reach the consumer, bring them in, and engage them in managing their health and care.

Source: HfS Research