Health Insurance Companies 

Strategic Sourcing and Spend Management Services for Health Insurance Providers 

Whether seeking service optimization, cost reduction or business model improvement, health insurance companies are recognizing substantial value from reducing operating costs and optimizing resources through strategic sourcing. 

The health insurance industry has been undergoing drastic changes ever since  the Affordable Care Act was introduced in 2010. Health insurance providers are required to operate more competitively than ever before;asked with providing better care policies at affordable prices while maintaining market share. In this environment, health insurance companies once comfortable with their growth model, are now faced with the challenge to do more with far less overhead. To survive in this setting, processes must be optimized, resources should be utilized more efficiently, partner relationships must be enhanced, and supply chain value must be maximized across all levels of the organization. 

Corcentric provides strategic sourcing services in unique spend categories to the health insurance industry which have helped  address challenges with solution-specific implementation. 

CHALLENGE 

  • High costs on claims recovery services 
  • Complex pricing models on wellness and fitness programs with low utilization levels 
  • Old and unmanaged relationships with professional services and management consulting firms 
  • Increased costs in member maintenance 
  • Increased competition and uprising costs to achieve competitive advantage 
  • Increased regulatory & compliance requirements with growing costs on legal advice 
  • Lack of spend control and transparency 
  • Contract management and contracting process inconsistencies 
  • Ever-growing demand for IT solutions and systems within a heavily regulated industry 

Corcentric’s SOLUTION 

  • Addressed through strategic sourcing services, evaluating “shared –recovery” pricing models, and identifying a provider’s position relative to the market 
  • Reconfigured through simplifying compensation and monthly facility visiting allowance structures 
  • Revitalized through supplier relationship management 
  • Amended through conducting a preliminary pricing review and diligent research process 
  • Considered by discovering a viable path to decrease the cost of member maintenance 
  • Addressed through a detailed knowledge of the spend category and marketplace 
  • Assessed through procurement transformation services 
  • Standardized through establishing agreements that deliver full transparency 
  • Combated through assessing potential supply bases and implementing best-in-class agreements 

Corcentric’s team of spend management experts can assist health insurance providers with: 

  • Benchmarking services 
  • Procurement transformation services 
  • Contract negotiation and contract management services 
  • Spend analysis 
  • Tailored cost reduction and strategic sourcing strategies 
  • Research on pricing, supplier identification and best practices 
  • Full RFX management 
  • Development of best-in-class contracts and legal-review-ready documentation 
  • Implementation, auditing and compliance management
  • Procurement and Sourcing Process Knowledge Transfer 

Corcentric has successfully supported clients in the health insurance industry with specialty and heavily embedded spend categories that are unique to the health insurance environment. Categories include GRC (governance, risk and compliance), wellness and fitness programs, claims recovery services, internal and financial audits, professional services, management consulting, translation services, staffing, marketing and printing, and banking services.