DEBUG: PAGE=domain, TITLE=Healthcare Payer,ID=1444,TEMPLATE=subprogram
toggle expanded view
programcode = HAIHPA
programid = 163
database = t
alerts = t
neat = t
vendors = t
forecasting = t
confidence = f
definitions = t

Search within: Healthcare Payer:

Access our analyst expertise:

Only NelsonHall clients who are logged in have access to our analysts and advisors for their expert advice and opinion.

To find out more about how NelsonHall's analysts and sourcing advisors can assist you with your strategy and engagements, please contact our sales department here.

Subscribe to blogs & alerts:

manage email alerts using the form below, in order to be notified via email whenever we publish new content:

has Database = t

Contracts Database

for Healthcare Payer

Track the pattern of service adoption by monitoring Healthcare Payer contract awards by your peers. Identify who are the successful vendors this industry now. Updated monthly!

These documents are available to logged in clients that have purchased access to this program.

has Confidence = f -- IGNORED

Conduent - Healthcare Payer BPS

Vendor Analysis

by NelsonHall Analyst

published on May 22, 2019

Access to this report is restricted to logged in clients with access. Login to get full access

Report Overview:

In January 2017 Xerox spun off its Business Services unit to create Conduent. This included Conduent's healthcare payer BPS business. Conduent continues to serve healthcare payer and provider clients, including government Medicaid agencies and commercial health plans.

Who is this Report for:

NelsonHall’s profile of Conduent’s Healthcare Payer Business Process Services (BPS) is a comprehensive assessment of service offerings and capabilities designed for:

  • Sourcing managers monitoring the capabilities of existing suppliers to deliver business process services to healthcare payers
  • Vendor marketing, sales and business managers looking to benchmark themselves against their peers
  • Financial analysts and investors specializing in the support services sector.

Scope of this Report:

The report provides a comprehensive and objective analysis of Conduent’s offerings, capabilities, and market presence in support of business process transformation through the application of healthcare payer BPS including the company’s:

  • Offerings and key service components
  • Delivery organization
  • Customer base, including the company’s targeting strategy and examples of current contracts (where available)
  • Revenue estimates for healthcare payer BPS
  • Strategy, emphasis and new developments in support of healthcare payer BPS
  • Strengths and weaknesses.

Key Findings & Highlights:

In January 2017 Xerox spun off its Business Services unit to create Conduent. This included Conduent's healthcare payer BPS business. Conduent continues to serve healthcare payer and provider clients, including government Medicaid agencies and commercial health plans.

In 2018 Conduent reports that Conduent's revenue from commercial and public sector healthcare customers will total approximately $1.7bn. This constitutes 29% of the company's 2018 revenue. NelsonHall estimates that Commercial payer clients contributed $664m and government payer clients contributed $1,245m in BPS revenue. Distinctive elements of Conduent’s payer BPS practice:

Government health services: Conduent's substantial business shrank from 2015, when it supported 31 states and D.C., to 2017, when it served 24 states, Puerto Rico, and D.C. Primary capabilities include:

  • Fiscal Agent Operations (supported by MMIS on two Conduent platforms in addition to state specific platforms
  • Provider Services
  • Program integrity
  • Pharmacy Benefit management.

Commercial industries: Conduent serves 19 of the top 20 health plans, 20 of the top 20 BCBS health plans, and many smaller payers.

  • Digital Transformation
    • Customer/member services (omni-channel communications offerings)
    • Claims administration (medical, pharma, dental/vision, workers comp. etc.)
  • Payment integrity (including overpayment ID, recovery, credit balance audits)
  • Care integration (including population health, member and provider communication)
  • Care management (utilization -, disease -, case management, patient outreach, wellness)
  • Private health insurance exchanges.

Conduent acquired a company relevant to its payer healthcare practice, Health Solutions Plus (HSP) and its Core Administration Processing System (CAPS) on January 3, 2019. HSP provides services to the following segments: commercial payers, managed care organizations (MCOs), and Medicare Advantage payers. HSP's software supports medical, dental, vision and specialty health benefits and claims administration. 

Login to get full access:

close