Healthcare Business Solutions Help more people stay healthy while increasing operational efficiency and reducing costs Connect with us × Delivering for our clients at scale 9/10 top U.S. health insurers 800M claims processed annually 6/10 top pharma companies Elevate performance and improve daily lives Healthcare payers, providers and pharma companies today are challenged with delivering essential services and medications against staffing constraints, limitations of technology and the need to reduce administrative costs. Our comprehensive suite of solutions and global experts can help you streamline operations and expand into new markets while ensuring members and patients receive the best care. *Source: McKinsey Increase accuracy Automate administrative processes and eliminate errors with the power of AI and machine learning. Enhance experiences Improve member experiences, minimize provider abrasion and increase patient adherence with scalable support. Lower costs Improve productivity and reduce administrative expenses with the latest automation tools and a global workforce. A full suite of solutions across the healthcare value chain As a leader in healthcare operations and insights, our people, processes and technology help actively engage members/patients, meet compliance requirements and optimize the cost of care while improving operational performance and health outcomes. Health Plan Administration Modernize operations, overcome staffing limitations and expand your market with tech-led solutions, expertise and a global team. Learn more Payment Integrity Identify and recover more overpayments while minimizing abrasion with advanced technology that combines multiple data sources. Learn more Community Health Solutions Elevate community health and whole-person care with our Healthy Communities Institute (HCI) that helps invest in partnerships and initiatives. Learn more Pharmaceuticals and Life Sciences Improve patient adherence and HCP engagement, capture adverse events, enhance your market reach and elevate outcomes. Learn more Featured insights 24+ year partnership with a major health plan leads to billions in recoveries Read the case study Advance your capabilities and performance: BPaaS solution for health plan administration Learn more How healthcare collaboratives transform population health – six takeaways Read the blog Unpacking the Healthcare Reduction Act: Implications for healthcare costs and access See the white paper Modernize with industry-leading solutions Leader in NelsonHall Healthcare Payer Operational Transformation Assessment 2024 Designated as a “Leader” based on strong core offerings for government and commercial health plans, including Medicare Advantage, and strong capabilities in automation of enrollment processing and document digitization. Learn more Leader in Everest Healthcare Payer Operations PEAK Matrix Assessment 2023 Recognized for supporting the healthcare payer value chain with innovative solutions that span member engagement, care management, claims management and risk & compliance. Learn more Leader in Everest Group PEAK Assessment of Healthcare CXM Service Providers 2022 Recognized as a "Leader" in Everest Group’s inaugural report in the top three of the highest performing categories: Market Adoption, Portfolio Mix and Value Delivered. Learn more
Health Plan Administration Modernize operations, overcome staffing limitations and expand your market with tech-led solutions, expertise and a global team. Learn more
Payment Integrity Identify and recover more overpayments while minimizing abrasion with advanced technology that combines multiple data sources. Learn more
Community Health Solutions Elevate community health and whole-person care with our Healthy Communities Institute (HCI) that helps invest in partnerships and initiatives. Learn more
Pharmaceuticals and Life Sciences Improve patient adherence and HCP engagement, capture adverse events, enhance your market reach and elevate outcomes. Learn more
Unpacking the Healthcare Reduction Act: Implications for healthcare costs and access See the white paper
Leader in NelsonHall Healthcare Payer Operational Transformation Assessment 2024 Designated as a “Leader” based on strong core offerings for government and commercial health plans, including Medicare Advantage, and strong capabilities in automation of enrollment processing and document digitization. Learn more
Leader in Everest Healthcare Payer Operations PEAK Matrix Assessment 2023 Recognized for supporting the healthcare payer value chain with innovative solutions that span member engagement, care management, claims management and risk & compliance. Learn more
Leader in Everest Group PEAK Assessment of Healthcare CXM Service Providers 2022 Recognized as a "Leader" in Everest Group’s inaugural report in the top three of the highest performing categories: Market Adoption, Portfolio Mix and Value Delivered. Learn more