Case Study

Combining Rightshoring and Design Thinking to Reduce Costs and Improve Value-Based Care

Industries
Insurance
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In 2000, a top 10 healthcare payer wanted to test the idea of handling claims management offshore to drive costcontainment and higher-quality outcomes. Based on HGS’s history of successful rightshore program management and process re-engineering, this payer asked us to launch a small proof of concept (PoC) program to show the viability and potential cost savings of taking this critical function offshore. From day one, the PoC was highly successful in driving process efficiency, cost-savings, and geographic diversification for our client. This initial success became the foundation for a growing multi-process collaboration, as HGS has played an increasingly consultative role in growing and transforming our client’s business. Since launching that PoC with only 23 FTEs, our relationship with the client has grown to encompass 4,000 HGS employees handling more than 150 different processes across seven different business units including back-office and clinical applications. Over these past two decades, HGS has delivered consistently strong performance for this payer client, driving real business transformation outcomes and efficiencies, including consistent year-over-year savings, by a combination of rightshoring and process reengineering.

This partnership success has driven the creation of a dedicated process re-engineering and improvement team, called Bright Ideas, staffed with business excellence and innovation personnel of both the payer and HGS. These teams work in close collaboration to develop, review, and implement new and innovative ways to improve all operational processes for the client.

OBJECTIVE

Across the operational landscape—from claims management to clinical support—this has been a partnership based on transparency and the trust earned by consistently exceeding our client’s goals/targets. In fact, this client recently chose HGS as the single partner among all service providers, for pioneering and deploying a revolutionary approach to member engagement and a new, client-branded member engagement platform. HGS’s success in proving and launching this new framework has resulted in the client solidifying plans to roll it out across all internal and external delivery centers next year.

HGS provides strong proof points and ROI at both ends of the lifecycle—member engagement and also the back-office process improvements that can cut turnaround times and improve provider engagement. “Service providers with both front- and back-office expertise are in a unique position to help clients achieve and exceed their objectives,” says Russ Uhlmann, HGS Vice President of Client Services. “HGS’s co-creation model and willingness to partner with our clients in proof-of-concept efforts, create both upstream and downstream insights and innovation to truly transform our client’s operations.”