The Opportunity
Health care payers have met new and significant challenges since the enactment of modern healthcare reform. The market has changed considerably and this provides an opportunity for forward-thinking organizations to excel and gain an edge on the competition.
The Challenges
The challenges for payers in today’s health care market are well known. The 80% Mandatory Loss Ratio (MLR) requirement, individual and small group guaranteed issue underwriting, risk adjustment, greater carrier competition and consumerism, and increases in the cost of care all contribute to the complex financial climate for payers.
Moreover, smaller and newer carriers are faced with challenges related to their small risk pool, higher administrative costs, and less favorable provider contracts.
To compete, payers must reduce costs while also retaining and attracting customers.
The Solution
VistaBPO offers payer solutions that save time, money and help you provide an elevated level of service.
VistaBPO helps by handling secondary business functions so you can focus on your core business processes. We provide services to increase member engagement and retention, maximize population health, optimize risk adjustment, and attract new customers. We offer technology solutions to assist both in new member enrollment and maintain your current member levels. We collect and analyze metrics to enhance organizational performance.
We help payers thrive by helping them reduce costs and enhance their customer service.
Discover how we can help you! Contact Us