Integrated delivery model helps major health plan thrive in new market dynamics
Our client, a leading health plan, faced a fragmented delivery landscape that hindered growth and efficiency. They sought HCLTech’s expertise to streamline operations, drive strategic transformation and lower total cost of ownership.
HCLTech responded with a bold vision—introducing an integrated delivery model. This modern approach went beyond mere operational improvements; it cultivated a culture of continuous innovation, setting new benchmarks for industry standards and best practices.
By aligning business and IT more closely, increasing automation and implementing rigorous quality controls, HCLTech not only reduced costs but also ensured consistency and reliability. The transformation also prioritized robust security measures, enabling the client to confidently serve their community with enhanced services and improved access to care.
Through these initiatives, HCLTech delivered on its promise, empowering the client to offer a stronger, more resilient foundation for its members. This partnership didn’t just change how the client worked—it transformed the very way they delivered value to their community.
The Challenge
Overcoming internal inefficiencies amid rising external business pressures
The client faced multiple internal challenges, including increasing technological debt, labor-intensive processes and a fragmented vendor ecosystem lacking accountability and scalability. These challenges led to higher total costs, reduced margins and significant operational inefficiencies, stalling key strategic initiatives. External pressures, including new regulatory mandates, rising consumer expectations and increased price sensitivity, further compounded these issues.
The Objective
To streamline IT service delivery by partnering with a single vendor, driving enhanced efficiency and consistency
The client aimed to simplify IT service delivery by transitioning from a complex multi-vendor setup to a single vendor partner, taking full responsibility for their IT, operations and infrastructure portfolio. The goal was to:
- Establish comprehensive accountability for IT, operations and infrastructure, and streamline workforce and delivery cycles to enhance efficiency
- Provide enhanced value, scalability and expertise through a unified approach
- Facilitate transformation to modernize their IT service delivery
- Achieve quicker cost savings by reducing complexity and improving operational efficiency
The Solution
A robust integrated delivery model that aligns ownership, infrastructure and business process functions
After aligning with the client’s vision and objectives, we implemented an integrated delivery model with clear ownership across IT, infrastructure and business processes. Our solution included:
- A factory model approach with vetted documentation and processes, best-in-class business process and service collections, a niche partner ecosystem and platform-agnostic best-of-breeds solutions
- Smart workforce governance with end-to-end accountability for better coordination and visibility to drive outcomes
- Transitioning from project-centric to product-based delivery, enabling service teams to align with business outcomes instead of timelines
- Right-shoring strategy that creates a global capacity model for round-the-clock efficiency and immediate access to talent
- Automation-first and GenAI-infused approach leveraging GenAI for service delivery and operations, including upfront automation across application management services (AMS) using reusable assets and pipelines
- Embedded productivity frameworks integrating SLAs across apps, operations and infrastructure services for continuous improvement and real-time performance tracking
- A dedicated risk and compliance office to meet regulatory and compliance needs across CMS, HIPAA and NCQA regulations
- Innovation-led transformation office to establish digital transformation, growth and innovation toward an 'enterprise of tomorrow' (application rationalization and API transformation).
The Impact
Driving efficiency and capital gains through a single contract with measurable outcomes
We delivered the program under a single contract with clear, predictable outcomes. The integrated delivery model has driven substantial operational efficiencies and capital gains, delivering measurable impacts across service lines:
- Over 30% productivity gain in IT and BPO functions
- 40% automation in AMS and infrastructure, yielding significant cost savings
- 40% reduction in technology debt
- 15-20% annual cost reduction through right-shoring and process optimization
- Improved alignment between business and IT, accelerating transformation
We remain committed to operational excellence and cost reduction, enabling the plan to leverage its enhanced capital base to further the essential goals related to the health and well-being of its member community.
