Healthcare Payers Technology Solutions & Services | HCLTech
Reshape patient care
Generative AI’s Impact on Life Sciences and Healthcare
Leader in Healthcare Digital Services
Overview

The healthcare industry is going through a paradigm shift to a member-centric, outcome-based model while adhering to the new regulatory and financial frameworks. This shift has created a need for more robust IT systems to enable digital transformation.

The accelerated shift towards a new digital experience, data interoperability, and overall stakeholder engagement enables the payers to uncover novel opportunities. Through increased collaboration, proactive sharing of patient data, and delivering highly engaging experiences, payers can capture member mind share and increase member retention.

We’re working with leading health plans to help them combine innovative digital solutions and data-driven insights with trend-setting stakeholder collaboration to achieve the quadruple aim – reduce the cost of care, achieve better outcomes, enhance member satisfaction, and improve healthcare professional experience.

Overview
Solutions

Our Solutions for Healthcare Payers

We offer a comprehensive suite of solutions tailored for healthcare payers, aimed at addressing their unique challenges. Our services include leveraging cutting-edge technology to reduce healthcare costs, enhancing member satisfaction through improved customer experiences, and ensuring regulatory compliance to minimize risks.

Reduce cost of healthcare through technology acceleration

Rising cost of healthcare and consequently medical loss ratio is leading to significant margin pressure for health plans translating into higher premium for members.

Tap into our digital offerings curated specifically to optimize cost of administration and clinical care that leverage data science and AI driven solutions built on digital first, cloud foundations.

Improve your customer experiences

The health insurance industry has witnessed one of the lowest Net Promoter Scores (NPS) due to lack of transparency, personalization and sophisticated digital capabilities.

Drive unparalleled customer experiences by leveraging automation and cutting-edge technologies to facilitate seamless collaboration and coordination. Our solutions address the 360-degree needs of members, providers, employers and brokers.

Maintain regulatory compliance

Many health plans struggle with remaining compliant to regulatory requirements and responding to new regulations in a timely manner due to archaic legacy systems and security controls.

Implement robust data security measures and electronic recordkeeping systems that align with industry standards and privacy regulations. We can help you leverage AI-powered tools to conduct audits, analyze claims data and monitor transactions, facilitating proactive identification of compliance issues and timely corrective actions.

Manage commercial, Medicare and Medicaid markets

Every health system has different requirements that are often not compatible with a single solution.

Manage IT platforms for health plans across commercial, Medicare and Medicaid (MMIS) domains through strategic digital adoption.

Improve health outcome with integrated care experience

Care fragmentation and lack of real-time data exchange across health ecosystem result in poor engagement and health outcomes for members.

Our healthcare interoperability, value-based care, prior authorization automation and holistic health solutions will help health plans deliver connected health experiences through proactive member engagement, real-time integration and collaboration with providers and plan benefit managers.

Increase accessibility and affordability

The acceptance of virtual care and national scrutiny around equitable care has created demand for services that improve access to care at an affordable cost.

Our digital health solutions for virtual care, remote patient monitoring and home health enable health plans to improve accessibility and convenience for their members. Our health equity, analytics and reporting solutions help health plans lay the foundations for equitable care for their members.

Case Studies

Success Stories from Our Work with Healthcare Payers

Awards and Recognitions

HCLTech rated as a Leader in ISG Provider Lens™ - Healthcare Digital Services, U.S. 2023

HCLTech rated as a Leader in ISG Provider Lens™ - Payer Digital Transformation Services, U.S. 2023

HCL Technologies rated as a Star Performer & Leader in Everest Group Healthcare Payer Digital Services Peak Matrix® Assessment 2022

 

Trends and Insights

Meet Our Ecosystem Partners

Adobe
Google
Infor
Microsoft
Salesforce
Pega
Oracle
IBM
Edifecs
Reveleer
Boomi
Mede/Analytics
Inovalon
Clarify
Innovaccer
Lyniate
Healthedge
Change Healthcare
Smilecdr
MPX Details Delivered
Health Axis
Catalyst Solutions
AHIP
HIMSS
Chime
HL7 International
HL7FHIR