Genpact and Nasco Partner to Help Power up the Blues

To serve consumers more effectively—and also meet the requirements of the medical loss ratio—the U.S. Blue Cross Blue Shield plans are looking to get leaner on the back end and heighten their focus and responsiveness to their consumer base: to cut administrative cost, but not at the expense of member and provider relationships. This is where NASCO has helped play a role for its BCBS Plan customers for more than 25 years—by originally providing a shared platform for claims processing, and then adding to the portfolio with member management and customer servicing products. To take the shared platform to the next level of efficiency and impact on business outcomes using digital technology and adding managed services, NASCO has partnered with Genpact.

This arrangement with Genpact will help NASCO (1.) digitize its claims, member, and customer servicing platforms and (2.) transition to an “As-a-Service organization” that will, in turn, help Blues plans meet the growing need for more efficient, competitive, customer-oriented services.

The first focus will be on core operations—to “power up” the healthcare back office, and drive unit cost down. NASCO today processes up to 300 million health claims per year for its member companies, and while much of it is automated, there is still about 5-10% that falls out through exceptions and must be manually processed. The partnership aims to drive this down further. Genpact will work with the NASCO owner plans—and eventually other interested BCBS companies as well—to analyze the current claims processes and suggest to partners at NASCO the changes to make it better as a shared platform. This is where the evolving relationship taps into the complementary strengths of Genpact—its well-known process reengineering expertise, and the emerging LeanDigital approach that brings together creative and iterative problem solving methodology with Six Sigma skills and digital platform options. In addition, Genpact will help create an outcome-based pricing model through the use of reengineering and automation, as it has done with other clients.

Beyond this initial focus on claims is a lot of potential for NASCO and Genpact to be a shared services provider to all Blue plans. The systems and processes generate reams of data that, if better harnessed, managed, and analyzed, could impact operational and financial results, as well as lead to better insight into the consumer and provider network to create stronger relationships and health outcomes. Genpact has been building out its Intelligent Insight Process Engine (IPIE) for analytics, an area the BCBS plans are increasingly focusing on to also better leverage data for member and provider servicing. The companies should be considering how they coordinate and redirect their talent toward more analytics-based and customer-facing activity over time.

The partnership is a nice complement for both parties, which bodes well for a long-term engagement. For Genpact, we see a clear message of how more clients are recognizing its capability in bringing together a heritage in operational excellence, analytics expertise, and labor arbitrage with an emerging technical capability and infrastructure to deliver on the promise of business-outcome based services, or what we at HfS call the As-a-Service Economy. NASCO plan companies, and eventually other interested Blue companies, can access Genpact’s proven Lean methodology and expertise in reengineering and industrialization, and the testing and application development capability it acquired with Jawood in structured and shared framework.

This commitment is a smart move for Genpact, which has a smaller practice and footprint in health care compared to its service provider competitors. The partnership builds on existing relationships and capabilities already woven in to NASCO, and provides an opportunity to become more integrated and integral to the shared services capability of the BCBS plans, through a unique niche and channel.