Healthcare ecosystem capabilities and experience can supercharge performance

The healthcare ecosystem is disconnected. Data across health plans, providers, and life sciences remains in silos. Consequently, value across the triple aim of care (reducing costs, improving health outcomes, and enhancing the experience of care) continues to deteriorate.

Service providers such as Cognizant can bridge this disconnect in the healthcare ecosystem thanks to their participation in multiple healthcare and life sciences markets. A reflection of these capabilities is seen in Cognizant’s significant wins at Boehringer Ingelheim, a large German pharma, and Horizon Healthcare Services, New Jersey’s largest health plan. These wins should give healthcare and life sciences enterprises confidence that Cognizant can translate its performance, experience, and ecosystem capabilities to help you win big too.

Cognizant helps Boehringer Ingelheim drive unprecedented, simultaneous four-vault implementations

Branded as the “One Medicine Platform,” Boehringer Ingelheim’s connected ecosystem is expected to be one of the largest global implementations of Veeva technology. Boehringer Ingelheim chose Cognizant as its systems integrator partner to simultaneously implement Veeva’s four vaults of Clinical Data, Clinical Operations, Quality, and Regulatory. Boehringer Ingelheim expects this holistic approach to increase interoperability and operational efficiencies and lead to reduced time for document submissions. Reduced time translates into getting faster, lower-priced therapies for those who need it, thus impacting the triple aim.

Cognizant’s implementation services include system architecture and design, training, data migration, integration, testing, and validation services.

Platform migration targets better interoperability and process improvements in drug development

Boehringer Ingelheim’s intent to embark on this unprecedented journey to implement Veeva’s four vaults simultaneously was rooted in simplifying and standardizing its clinical development functions. Boehringer Ingelheim’s ambition to migrate to four vaults focused on delivering positive effects on interoperability, efficiency, and process improvements. This change could consequently impact outcomes in the drug development value chain.

Boehringer Ingelheim selected Cognizant as an implementation partner based on its ability to provide services at scale and its experience in implementing end-to-end clinical development systems. Cognizant’s experience addressing interoperability challenges across the healthcare ecosystem gave it an edge with the quadruple vault implementation.

This implementation is still in its early stages, and the company expects these outcomes:

• Speed to market: Develop faster migration of molecules to treatments for patients.
• Supporting the pipeline: Support the unprecedented rich pipeline of therapies.
• Growth culture: Strengthen a digital culture that empowers employees and enhances the experience for patients, investigators, and colleagues.
• Data-driven organization: Improve data quality and utilization in drug development.

Many eyes in the industry will be on this transformational effort, the first of its kind, as its success will likely encourage other pharmas to follow a similar path. In particular, it will improve the speed to market, which can help health consumers access therapies faster and improve their health outcomes.

Cognizant wins a seven-year Horizon renewal powered by performance

Horizon Blue Cross Blue Shield of New Jersey is the state’s oldest and largest health plan. Its plans include commercial groups, Medicare, Medicaid, vision, dental, and more. Horizon’s managed care organization for Medicaid covers more than one million lives, including dual eligibles. Horizon initially partnered with Cognizant in 2016 to address the technology enablement needs for its Medicaid plans, such as NJ FamilyCare and Horizon NJ TotalCare. In April 2023, Horizon renewed its partnership with Cognizant through the end of the decade, a seven-year agreement to manage claims processing, encounters submissions, provider configurations, and enrollment services.

Performance, experience, and cross-industry capabilities were key drivers for Cognizant’s renewal. Its past performances provided Cognizant with the credibility and confidence to sign up for enhanced outcomes, such as the availability of systems, compliance, and claims management on a go-forward basis. Cognizant will leverage its TriZetto platform, which remains one of the most robust platforms for end-to-end health plan operations, including benefits, care management, claims, and customer service. Finally, Cognizant has around three decades of experience with government programs across multiple states, which gives it a deep understanding of Medicaid while continuing to augment operations with enhanced best practices.

In the last audit (2021-22) published on behalf of the NJ Department of Human Services, NJ FamilyCare met its technology system commitment and compliance with Cognizant and its process standards listed below:

• Data integration and systems architecture
• Claims and encounter data systems and processes
• Membership data systems and processes
• Provider data systems and processes
• Oversight of contracted vendors
• Supplemental databases
• Grievance systems

Cognizant’s partnerships with Horizon and other health plans drive the development of systems that improve interoperability and set the stage for cross-industry connectivity.

Cognizant’s Boehringer Ingelheim and Horizon wins strengthen its ability to connect the healthcare ecosystem around the health consumer

A critical opportunity for healthcare in the US is the possibility of unifying the different segments that make it up. The US healthcare ecosystem, as represented in Exhibit 1, is perhaps the most organized yet complex ecosystem given the different sets of stakeholders. This perpetuates the disparity of systems, siloed delivery, and inherent inefficiencies, leaving the health consumer to hold the bag on costs, experience, and health outcomes.

Exhibit 1: Connecting the healthcare ecosystem around the health consumer is essential to improving human health.

Source: HFS Research, 2023

While the narrative to connect the ecosystem is strong, participation is difficult and so are the identification and alignment of the right set of incentives. Still, some enterprises can thread that needle to connect the healthcare ecosystem.

Cognizant is one such enterprise; it has the capability and the capacity to create the connections required. Cognizant operates across the healthcare ecosystem addressing health plans, providers, and life sciences reflected by their marquee clients. This gives Cognizant deep insights into domain specific delivery and operations. All of this allows them to form alliances and develop interoperable systems to connect the sub-segments, a necessary precursor to addressing the triple aim of care.

Despite Cognizant’s technology capabilities, there are people, process, and regulatory constraints that make connecting the healthcare ecosystem extremely challenging. So, healthcare enterprises must factor those challenges into their efforts to collaborate across the ecosystem and create value.

The Bottom Line: The trifecta of performance, capabilities, and experience can earn a license to address complex challenges and make outsized impacts on human health.

Life sciences, health plans, and other segments of the healthcare ecosystem continue to be target-rich environments for transformation to better address the needs of health consumers. Cognizant’s recent wins highlight the necessary ingredients for enterprises to partner and address opportunities together.