HfS Blueprint Report: Population Health and Care Management 2016

Jul 27, 2016 Barbra McGann


In the 2016 HfS Population Health and Care Management Blueprint Report, we cover themes in Business Process Services, focusing on Business Process Outsourcing and Business Process As-a-Service as well as an analysis of 10 service providers in this industry. It’s about how clients and service providers are using automation, analytics, and  BPaaS  business models to enable population health and care management to impact health, medical and administrative outcomes. Services include healthcare consumer engagement, care management, utilization management, and performance management.  



  • Population Health and Care Management are critical focus areas for healthcare organizations that are or are moving to risk based and value based care. They will be paid on health, medical, and cost outcomes. They need to be able to track and report on these outcomes, and also improve the results.
  • Many healthcare organizations could tap into —or better leverage current partnerships in outsourcing—to address these areas. For example, healthcare providers may not have the resources to address  risk management and care management; healthcare plans/payers often lack the the trust of the patients/members, or the clinical data necessary for constructive engagement. It’s the combined set of data and capability that can make a difference. Data integration and interoperability are essential elements. 
  • Service providers have been providing services in each of these areas that can help impact the health, medical, and administrative outcomes. They have mostly operated with point solutions, and for payers or providers, not both. Also, most of the outsourcing has been labor arbitrage and basic use of workflow, if that. We see service providers investing in hiring and developing healthcare experts, analytics expertise, and looking for ways to develop and sell “utilities” that use cloud-based software (with automation) to augment labor that can then be reassigned, and retrained as needed.



  • Executive leaders and business unit leaders, shared services and outsourcing and procurement managers at Healthcare Providers, Payers, Healthcare Association (e.g., NASCO, HIMSS), Pharma companies



Accenture, Cognizant, Dell, EXL, HCCA Health Connections, HCL, Hinduja Global Solutions (HGS), Sutherland Global Services, ​​Wipro, Xerox


Readers will see how a set of service providers with a history in healthcare BPO are aligning, packaging, building, partnering, and acquiring capabilities to help organizations operate more efficiently and effectively. You'll also gain some insight into the capability, culture and investment priorities of these service providers. We share examples of how automation, analytics, and BPaaS are or could be used in healthcare operations through partnerships with service providers. And we outline the strengths, investment priorities and challenges to take into consideration regarding the service providers we covered. Finally, we provide recommendations for partnering in the future for greater impact on business results.



HfS Blueprint Report: Population Health and Care Management 2016

(69 Pages)

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