Cognizant’s Healthcare BPO practice<\/a>, to see if we can make some sense of it all.<\/p>\nSumit has spent last 8 years of his career in the Healthcare BPO industry and has seen it evolve. He joined Cognizant BPO in 2006 as a part of the initial management team and has been \u00a0instrumental in its growth.\u00a0Prior to Cognizant, Sumit worked with Hexaware and Xerox India in various roles, before relocating over to the States.<\/p>\n
<\/span><\/strong><\/p>\nA dedicated globe-trotter, you’ll always find Sumit sampling some local cuisine or culture… or even climbing a mountain, like Mount Pilatus, nearly 7,000 feet up in the Swiss Alps. \u00a0And a mountain’s a pretty good metaphor for the healthcare sector. It’s massive, hard to figure out, and riddled with uncertainty. So we turned to Sumit to brief us on why there’s so much activity in the healthcare sector, and the impact of healthcare reform in the US…<\/p>\n
Phil Fersht:<\/span><\/strong> Sumit – thanks for taking time to talk to HfS\u00a0Research today. \u00a0So tell us about the healthcare business. Why is it so busy right now?<\/span><\/p>\nSumit Sachdeva:<\/strong> Oh, there\u2019s quite a bit of momentum that we have. So that\u2019s keeping us busy. We\u2019re all set for a significant growth this year and are expecting this trend to continue for the next year or two.<\/p>\nPhil:<\/span><\/strong> <\/span><\/strong>What sort of work are the clients demanding? \n<\/span><\/p>\nSumit:<\/strong> I think across the board, different types of customers are looking at different pieces of the pie but – once at the table – you can end up having several different discussions! We\u2019re more focused on the vertical services – the very\u00a0core<\/em> operational areas within health plans. And there is significant demand in those services I feel. <\/p>\nPhil:<\/span><\/strong> <\/span><\/strong>So, the fact that you are vertically focused\u2013is that playing to your advantage in the healthcare space?<\/span><\/p>\nSumit:<\/strong> I think so, because what\u2019s happening is that when you go and position yourself as, \u201cHey, I can do F&A or I can do HRO or I can do procurement\u201d and all of that kind of stuff and then you also say \u201cI can do also claims, etc.,\u201d what happens is that when you\u2019re talking to the business guys who are the core functionaries\u2014not the CFO or not the procurement organization, etc., when they see this array of services, they feel that you are generalist BPO company. Right?<\/p>\nBut when we go to them and say, \u201cHey, you know what? This is our service offering. This is what we will breathe, eat and sleep,\u201d I think we start seeing the discussions are a little more focused.<\/p>\n
I think the vertical BPO push and positioning that we have been following for the last three years is now gaining ground in the industry. In fact, in the last analyst session we had in New York, a lot of people were curious about, \u201cHey, I heard about this vertical BPO. What is it? How is it different?\u201d So I feel that it\u2019s gaining traction. What\u2019s your take on it?<\/p>\n
Phil:<\/span><\/strong> We\u2019re currently ascertaining the current environment and whether health reform has been impacting sourcing demand from several healthcare organizations. I think it\u2019s taking a long time to get the legislation introduced and then pushed through the key channels. However, we\u2019re definitely seeing increased pressure and interest from the buy-side to look at specific processes. We\u2019re seeing a lot of interest in claims processing, revenue cycle management services, for example. Is that where you folks are seeing most of the growth in terms of your process focus?<\/span><\/p>\nSumit:<\/strong> Yeah. I would put it into different buckets. So if you look at the large plans where they have outsourced a lot of the low-end work, those type of health plans are now starting to look at, \u201cHey, what else can I do? How can I get ready for this change and reform and control my costs?\u201d So they are pushing things to the next level. So, for example, \u00a0we\u2019re seeing this huge demand coming in, in terms of benefits configuration because as we all know that the healthcare reform is going to have an impact on the benefits plans. So starting right now, as an example, coverage denial for children with pre-existing conditions has gone away, the lifetime limits have been removed from several plans etc. So there\u2019s a significant demand for how to go about making those changes into the benefits plan. Now if you\u2019re a BPO organization, it\u2019s very difficult for you to get into that space because it\u2019s a fairly high complexity, high domain area. But since we\u2019ve had invested in those kind of domain competencies, it has been easy for us to get in and start growing into that space.<\/p>\nSo that\u2019s one example of how the healthcare reform is driving demand in more complex areas. When you come to the smaller and mid-sized plans\u2014typically more of the smaller plans where they\u2019ve had couple of systems or their systems are a little arcane and they\u2019ve been very manual\u2014they are increasingly coming under pressure to do something regarding their whole operations because with the healthcare reform coming in, they know that their costs had to come down. But more importantly they have a looming regulatory requirement of complying with HIPAA 5010 and ICD-10 changes, which are pretty big changes and would require significant outlay. Especially when you have two or more systems, that\u2019s where the dilemma is coming in: \u201cHey, what do I do with the two systems? Do I remediate two systems and double my 5010 and ICD-10 remediation cost? Or should I use that just as a point and consolidate it into one system? And is my system, the right system\u2014or should I look in the market and get another system?\u201d<\/p>\n
So, I think, in that sense you\u2019re seeing a kind of a trend picking up where some of the smaller plans are now looking at more of an end-to-end service. \u201cYou bring the platform. You kind of do the whole IT and BPO and infrastructure combined and just give me the service.\u201d<\/p>\n
Phil: <\/span><\/strong>Do you feel that the way BPO is moving in healthcare, it\u2019s going to remain on a vertically-centric course like this? Or do you think that we\u2019re going to see more horizontal areas like HR and finance open up in time?<\/span><\/p>\nSumit:<\/strong> I think so for some time. I think that the horizontal services will open up. We\u2019re seeing some initial trends however timing is something that we need to look for. The reason why I\u2019m saying timing is that there are only so many balls an organization can juggle at a given point in time. So what\u2019s happening right now is that there is so much pressure and so many changes currently happening in the environment for the next two or three years.<\/p>\nI don\u2019t know how much focus would be there on, for example HR or F&A, which in a health plan environment would have a limited impact on their operations side. To give you a sense of the scale, for example, a large healthplan might have 200 to 300 people in finance and accounting but they would have 5,000 to 7,000 people in claims. So where\u2019s the bigger bang for the buck? That\u2019s something that will probably drive some of that timing.<\/p>\n
Phil:<\/span><\/strong> Do you feel that most of the client situations you\u2019re getting pulled into require both a technology as well as a process element? Or do you feel a lot of it is very process-only type engagement at this point?<\/span><\/p>\nSumit:<\/strong> I think, like I said, smaller organizations are looking for a lot of platform stuff. The larger organizations understand that a combination of technology and process can play a very key role in terms of driving the process to the next level. And that where IT+BPO Synergy plays a key role. There are two key contextual pictures here<\/p>\nWhen I interact with customers across the board, one of the things that continuously comes out is: \u201cWe know that there are low-hanging fruit that can be leveraged and have a good ROI, if you just look at it in the context of a particular process. But in the context of the larger organization, that ROI is relatively small so we never get that budget or that focus or attention to do this particular kind of IT initiative.\u201d So when we come in as a vendor, we just focus on that particular process. It\u2019s much easier for us to bring that attention and that focus to drive that process improvement. And a lot of times, these kind of opportunities get built in pricing of the contract, etc. So that is one context.<\/p>\n
Then the second context is where the customer says, \u201cWe understand that there are opportunities for process improvement. And we also know that there are so many different opportunities that we won\u2019t be aware of. So if an organization can come in and drive this process enhancement, they feel that \u201cOkay, I\u2019m going to get the assured benefit of the identified opportunity but there are opportunities to get more.\u201d<\/p>\n
So that\u2019s what the buyers are starting to look at and that\u2019s where that whole IT\/BPO synergy kind of thing starts to play very effectively.\u201d<\/p>\n
Phil:<\/span><\/strong> All right, so what do you think are the main barriers holding back firms in the health care from looking at global sourcing right now? Is it still a big barrier for them to cross\u2014to think about using the sources outside of the country etc? What do you see?<\/span><\/p>\nSumit:<\/strong> <\/strong>I think the barriers, if I may say, are, in the current economy\u2014obviously, job losses. Spreading all of that information in the community which they service is an important factor that starts going in their mind.<\/p>\nThe second piece is the appetite to undergo that change, because healthcare organizations have typically had the opportunity to continuously increase their premiums, although they have been under pressure to reduce costs. But that pressure has not been as intense as in some other industries, like manufacturing, retail or even banking and financial services.<\/p>\n
And the third factor is a tendency of a lot of people internally thinking that, \u201cHey, we are here for the good of the society. We service the society.\u201d So that is the kind of mentality, especially in the hospital side. But that is changing now because we are seeing that people are saying, \u201cWe are doing Social Service, we are not for profit but then I need to be viable to survive. I need to make sure that I\u2019m covering my costs.\u201d<\/p>\n
I think those are some of the reasons this industry has been a late starter. But now those perceptions are changing, people are becoming more business- and top-line-, bottom-line-focused. And so that\u2019s why we are seeing a little more traction. It will take a little time for that momentum or inertia to move more in the offshoring and outsourcing direction.<\/p>\n
Phil:<\/span><\/strong> <\/span><\/strong>In terms of the Healthcare Reform Act, is this something that you\u2019re seeing driving a lot of these decisions right now? Is it very much on people\u2019s minds when you talk to your clients or do you still think that it\u2019s being put on the back burner until it actually comes into action? What\u2019s been your experience?<\/span><\/p>\nSumit:<\/strong> <\/strong>I think definitely Healthcare Reform is forcing organizations to rethink their strategy and their business model. There is opportunity and there are challenges. They\u2019re kind of both. A lot of organizations are now realizing that the only way to address the Healthcare Reform is to control your costs or optimize your costs and at the same time, grow. If you do just one of them, the chance of survival will be very limited. So that\u2019s where it gets challenging for the health sector.<\/p>\nIf you have to optimize cost then how do you invest in growth? How can you do that in combination?<\/p>\n
And that\u2019s where a lot of organizations are thinking about: \u201cHey, should I look at outsourcing? Should I invest the dollar that I have to focus on growth and then leverage a strong partner to help me in terms of optimizing some of my costs?\u201d I think that\u2019s the kind of thinking that is permeating in the industry in several places that we\u2019ve been interacting and having some discussions with. However people are still kind of absorbing the whole impact.<\/p>\n
They\u2019re still strategizing how they are going to look at the next four years in terms of the reform and its impact. Before they were looking at how the first wheel of changes get accepted, acknowledged, etc., and now this anxiety for the November elections is also something that, especially from an outsourcing perspective, is making people, take a wait and watch approach. \u201cLet this election pass. Let\u2019s see what happens. The government policies might take a change or turn or whatever it is.\u201d So I think that\u2019s where a lot of organizations are, especially the medium and the smaller ones. There are certain organizations which are some of the more aggressive organizations have or some of the organizations have already decided that: This is an opportunity to make a big change so let\u2019s go ahead and do that.\u201d So we are seeing more actions in there. They are some of the more progressive organizations.<\/p>\n
Phil: \u00a0Sumit – thanks so much for your time today – our readers will certainly appreciate your insights and experiences.<\/span><\/p>\nSumit Sachdeva (pictured) is Head of Cognizant’s Healthcare Business Process Outsourcing practice. \u00a0He can be reached at sumit dot sachdeva at cognizant dot com<\/span><\/em><\/span><\/p>\n","protected":false},"excerpt":{"rendered":"Sumit Sachdeva, Head of Cognizant's Healthcare BPO Practice, atop Mount Pilatus in the Swiss Alps Healthcare has been on everyone’s…<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[48,835,61,64,79,81,838,88],"tags":[],"organization":[],"ppma_author":[19],"class_list":["post-1602","post","type-post","status-publish","format-standard","hentry","category-business-process-outsourcing-bpo","category-f-a","category-financial-services-sourcing-strategies","category-healthcare-and-outsourcing","category-hr-outsourcing","category-it-outsourcing-it-services","category-kpo-analytics","category-outsourcing-heros"],"yoast_head":"\n
A healthcare BPO summit... with Sumit - Horses for Sources | No Boundaries<\/title>\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\t \n\t \n\t \n