Healthcare Payers

What is happening in this space?

The wave of reforms since 2009 has altered several equations across the US healthcare ecosystem. The departure from conventional models such as the much criticized, Fee for Service (FFS) to Value based purchasing (VBP) itself is a fundamental change for payers. In addition, widening of the insurance coverage amongst the population has resulted in another major change. With individuals buying their health plans off the insurance exchanges, payers erstwhile used to the B2B model, are forced to adapt to become B2C sellers. With the reforms pushing digital transformation of the healthcare industry and empowering the patients, the consumers of healthcare are more informed and demanding than ever. This wave of consumerism has started a race and the ones who appeal to the consumers will emerge victorious. Invariably, most if not all of these changes have a significant technology implications. Information technology is the lever that has and continues to empower the consumers. Nalashaa equipped with its technology expertise and deep understanding of healthcare domain, is well positioned to help payers address their business challenges by leveraging technology.

With skilled resources having experience across various systems in the payer environment, Nalashaa is the right technology partner that can enable healthcare payers to focus on their core business.

Nalashaa can help Payers optimize their operations

We realize that many payer systems are still on legacy technologies such as FoxPro, Delphi and AS400 etc. As the skills required to support these obsolete systems become scarce, we help you maintain these for you till you decide to move on to more modern technologies. 

Healthcare payers deal with myriad of systems to receive clinical data. With years of experience in working with healthcare technology solution providers, we understand the systems on the other side of the payer world and realize the importance & meaning of the data sent from them. Hence Nalashaa is well positioned to help payers build the necessary bridges to such systems in a matured manner. 

The amount of data that payers generate, receive and process is enormous. Often this data resides in disparate systems and needs to be cleansed, reorganized, transformed and finally presented in a meaningful way to derive business insights. We have the necessary skills to support you with this increasingly important need. 

With the consumer gaining the center stage, there are innovative ways in which several players are trying to delight their consumers. With the popularity of mobile platforms, there is a plethora of possibilities for payers to engage their customers. With years of experience in developing mobile solutions enabling sentiment analysis, predictive modelling and related concepts, we are well positioned to work in tandem with you to engage your customers better. 

With years of understanding of your systems from Member management, Claims administration, Fraud & abuse analysis, Network management, Care management and various other areas, we can help you build, enhance and/or maintain your systems.