The payer marketplace, like the overall healthcare industry, is undergoing a digital transformation journey. The focus of payers continues to be to improve the health outcomes of its members by providing accessibility to the best and the most affordable care possible.
To deliver on these objectives there is significant transformation, of both business models and technology capabilities, that is occurring. Payers are focusing on the continued move from fee-for-service models to value-based care models. This is happening across segments - commercial, individual, and government business. There continues to be Payer - Provider - PBM convergence in the marketplace, to integrate capabilities, improve efficiencies and ultimately reduce overall costs. Payers are also continuing to engage in innovative Digital Healthcare Technology. From experimenting with new technologies to significant investments in digital health startups, they are looking to adopt technologies that can provide business value. The healthcare marketplace is also continuing to see an explosive number of vendors attempting to provide solutions for the connected customer experience.
Virtusa is working with the largest payers in the nation to navigate through these challenges and to deliver on their vision for enterprise transformations, digital health innovations, and improving care delivery for its membership.
Virtusa's PLM solution can be built upon leading enterprise BPM and SFA platform capabilities. PLM addresses the many challenges Payers face in Prospecting, Contracting, Onboarding, Credentialing, Pricing Configuration and Servicing for Providers.
Virtusa’s Pega based A&G solution offers simplified case management, and automated task handling, coupled with AI-based appropriate classifications, that ensure accelerated case resolution.
End-to-end cloud-based service offerings that span the entire software spectrum from assessment, migration, implementation, and integration. We accelerate cloud adoption through domain expertise and strategic partnerships with major cloud providers.
Our consultative and advisory services help us identify the right business, functional and sub-functional areas for focus, shortlist KPIs, and prepare a detailed future-state functional architecture. Our solution includes five key capabilities to help payers achieve profitable outcomes.
Virtusa has partnered with IBM® Watson Health to lead digital transformation in healthcare.
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