Modularity can optimize core admin functions and deliver better outcomes

The market is fairly dense with core administration processing (CAP) platforms, and every platform provider is trying to differentiate itself. While the industry has long relied on these monolithic platforms, the trend has shifted toward modular architectures that enable incremental modernization and optimization. These address rising consumer expectations, regulatory pressures, and digital experiences.

A modular approach, such as Infosys Helix, offers a pathway, enabling payers to address immediate challenges, reduce tech debt, and embrace innovation without the cost, risk, and disruption of services. This approach enables health plans to prioritize immediate pain points without undertaking the immense burden of a complete overhaul.

Modular structure simplifies modernization, supports scalability, and minimizes risk

Infosys Helix’s modular platform is designed for seamless integration with existing infrastructure, leveraging open APIs to ensure interoperability and enabling SaaS and BPaaS models. Each module operates independently, allowing targeted improvements in critical areas such as member enrollment, claims processing, and provider lifecycle management. This “Lego-like” approach enables health plans to dismantle monolithic architectures and replace them with adaptable, cloud-native systems over time. Exhibit 1 shows the modular approach used by Infosys Helix to streamline payer business functions, from member enrollment to provider management.

Exhibit 1: Infosys Helix’s modular architecture decomposes the functional parts, targeting faster execution

Source: Infosys, HFS Research, 2024

Another key attribute of Infosys Helix’s modularity is the continuous feature releases (every 4-6 weeks) to adapt to regulatory changes, implement bug fixes, and add new capabilities as part of the release cycle. This approach ensures ongoing risk mitigation while delivering critical functionality.

Proven and transformative outcomes validate the modernization effort

The Infosys Helix subscription model starts post-implementation, reducing initial client costs and risks. Infosys Helix has achieved tangible outcomes for its clients. A few examples include:

• Member enrollment transformation: Leveraging Infosys Helix, a leading health plan achieved a 70% reduction in enrolment exceptions, with 90% of enrollments handled via electronic straight-through processing. Additionally, it saw a 60% decline in member enrollment-related calls and a significant (>100%) improvement in electronic enrollment record throughput. The platform has been successfully implemented to serve more than 300,000 members to date.
• Plan sponsor intake, billing, and enrollment: Infosys Helix helped another health plan achieve a 30% reduction in turnaround time for plan sponsor renewals, a 20% increase in productivity for new plan sponsor onboarding, and a 40% increase in throughput across case install, ID card, and billing workstreams for the middle market segment. Additionally, the company realized a significant improvement in electronic enrollment record processing throughput. The platform is set to support more than 10,000 groups across multiple US states, with plans to expand its use to additional segments, further enhancing operational efficiency.

The Bottom Line: Infosys Helix’s modular approach helps manage risk, controls costs, and accelerates timelines, allowing health plans to modernize functionally.

The modular structure of Infosys Helix enables immediate pain-point resolution and long-term innovation. Enterprises should properly evaluate the value they expect from the admin core platform according to their varying priorities and strategies. The adoption of any platform requires a rigorous evaluation; here are key points to consider:

• Integration capability: Ensuring compatibility with existing infrastructure.
• Cost advantage: Despite reduced initial investment compared to monolithic transformations, enterprises must assess the long-term ROI and scalability of modular upgrades.
• Client Outcomes: Enterprises must verify the platform’s ability to help enterprises achieve their vision.