WNS - Healthcare Payer BPS
Who Is This Vendor Assessment For?
NelsonHall’s profile of WNS’ healthcare payer Business Process Services (BPS) is a comprehensive assessment of service offerings and capabilities designed for:
• Sourcing managers monitoring the capabilities of existing suppliers to deliver business process services to healthcare payers
• Vendor marketing, sales and business managers looking to benchmark themselves against their peers
• Financial analysts and investors specializing in the support services sector.
Key Findings & Highlights
WNS Global Services is a public, global BPS company headquartered in Mumbai, India. The company generated $758m in fiscal year 2018 (ending March 31, 2018).
WNS serves clients across a diverse set of industries. Within healthcare, WNS serves payers, providers, and life sciences clients. WNS’ payer BPS business was significantly expanded in September 2017, when WNS acquired analytics and care management company HealthHelp for $95m. This privately held, Houston, TX, company was founded in 1999. Since this acquisition, WNS healthcare vertical revenue is approaching or exceeding 15% of total revenue. This acquired entity still operates under its prior brand name (“HealthHelp, a WNS Company”). The combined healthcare payer BPS business under WNS ownership will be referred to below as WNS.
NelsonHall estimates that WNS payer BPS revenue from commercial clients in calendar year 2018 was approximately $45m. The impact of the HealthHelp acquisition was substantial, as NelsonHall estimates that payer BPM revenue over the prior calendar year had totaled only $6m.
WNS now serves over 20 payer clients, including two national payers, across multiple business lines and over 50 different insurance products. As clinical support to its payer clients, WNS data, software, and personnel facilitate collaboration with providers in providing members/patients with the best and most cost-effective care.
WNS offers particular expertise for healthcare payers across the following disciplines:
• Medical management
• Care and population health management
• Provider management
• Health intelligence and analytics
• Claims management
• In terms of clinical specialties, WNS is focused on radiology, cardiology, oncology, pain, spine & orthopedic, sleep Care and specialty drugs.
WNS employs healthcare payer BPS resources in 8 locations across the U.S., the Philippines, and India. These personnel include approximately 700 clinical specialists that facilitate collaboration between payers and their provider networks. Over 400 WNS staff supporting healthcare payers are employed in the United States. This includes over 100 nurses.
WNS’ cross-functional medical management program teams are comprised of MDs, medical statisticians, PhDs, and analytics technology experts that work together to implement WNS’ proprietary “trendbender” methodology in order to improve client medical cost/quality/safety metrics.
• When necessary, WNS draws on high-quality consultative expertise from its network of over a dozen partner clinical organizations.
Scope of the Report
The report provides a comprehensive and objective analysis of Hexaware’s offerings, capabilities, and market presence in support of business process transformation through the application of healthcare payer BPS including the company’s:
• Offerings and key service components
• Delivery organization
• Customer base, including the company’s targeting strategy and examples of current contracts (where available)
• Revenue estimates for healthcare payer BPS
• Strategy, emphasis and new developments in support of healthcare payer BPS
• Strengths and weaknesses.
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