Operational Transformation in the Healthcare Payer Sector: 2020

Operational Transformation in the Healthcare Payer Sector: 2020

Who Is This Report For?
NelsonHall’s “Operational Transformation in the Healthcare Payer Sector: 2020” report is a comprehensive market assessment report designed for:
• Sourcing managers investigating operational transformation developments within the healthcare payer sector
• Vendor marketing, sales and business managers developing strategies to target operational transformation and business process services (BPS) opportunities within the healthcare payer sector
• Financial analysts and investors specializing in the IT services and BPS sector.

Scope of the Report
The report is based on interviews with executives in the healthcare payer sector in the U.S., U.K., Continental Europe, and Asia Pacific.
The report analyzes the worldwide market for operational transformation and business process services within the healthcare payer sector and addresses the following questions:
• What are the principal business priorities faced by organizations in the healthcare payer sector?
• What benefits are sought from operational transformation by healthcare payer firms?
• In which functional areas are healthcare payer firms planning operations transformation initiatives?
• What initiatives are healthcare payer firms planning around key technologies such as analytics, AI, and IoT?
• To what extent, and how, will BPS vendors be involved in operations transformation?
• What are the key characteristics sought in an operations transformation partner by healthcare payer firms?
• What levels of productivity gain are being targeted by healthcare payer firms?

Key Issues & Highlights
Healthcare payers are in a highly competitive industry. Healthcare payers globally cited a need to maintain and enhance their market shares through improving their marketing and new customer acquisition effectiveness while improving their customer retention through an enhanced end customer experience and their levels of collaboration with healthcare providers.

At the same time, healthcare payers do need to continue to reduce their administrative costs and levels of fraudulent claims while ensuring high levels of ongoing compliance.

As a result, operational transformation is highly important, with the overwhelming majority of healthcare payers (88%) perceiving operational transformation to be a key element in their organization’s future strategy.


1. Introduction
2. Executive Summary
3. Market Forecast
4. Key Business Issues & Initiatives
Business Issues
Operational Transformation Initiatives by Process
5. Operations Transformation Initiatives by Technology
6. Impact of Operations Transformation on Sourcing
7. Impact of Operations Transformation on Productivity & Expenditure

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