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Payers look to contractors for help as healthcare reform continues to drive change in the industry. From cutting costs to processing claims, there is an urgent need among payers for outsourcing. Claims management services are expected to see the biggest spike in growth in the coming years¹.

Payer services make up a large portion of the healthcare business processing outsourcing (BPO) market. According a recent report by Markets and Markets, the healthcare BPO market as whole is expected to hit $276.79 Billion by 2021¹. The BPO market is segmented into provider services and payer services. Driven by pressures to reduce healthcare costs and improve quality measures and delivery of care, the BPO market is thriving.

A new survey by Black Book Market (reported by Healthcare Finance) predicts the payer segment of healthcare BPO will drive a “22% year-over-year increase in outsourcing services².”

Payer Outsourcing Services

  • claims management
  • front-end/back-office operations
  • member management
  • provider management
  • finance and accounts
  • analytics and fraud management
  • HR services

“BPO vendors are helping public and private payers achieve great efficiency and cost savings, improve transparency and member services, and enhance the health plans’ ability to participate in the reforming healthcare business models,” Doug Brown, managing partner of Black Book

Black Book Market surveyed a total of 5400 health plan over the course of 2 years.

Key Findings²:

  • Traditional BPO services rose 13%. “Even as 7.2 million new members enrolled in ACA plans and millions more gained coverage through Medicaid managed care.
  • Contracting has doubled for “analytics, new plan design, claims modernization and alternative payment services.”
  • 87% of health plan managers listed software-as-a-service, accountable care and chronic care management assistance, data aggregation, health information exchange and data security as priorities.
  • 75% of the respondents said that outsourcing for value-based payment models was something they invest in
  • 70% of the managers surveyed said that outsourcing was among “the best solutions”
  • Almost half of the small- to medium-sized plans surveyed said they were already outsourcing for some processes

You can read the full article Healthcare Finance article on the Black Book Market survey here.

Building transparency, credibility, and confidence for your organization, an outsourcing partner solidifies valuable attributes to aid in your organization’s success. Reduce risk and make confident decisions by selecting BHM Healthcare Solutions for your outsourcing needs.