Sandeep Dutta, Senior Vice President and Head- Healthcare & Life Sciences at Mphasis
Sandeep has 22+years of international experience covering IT, BPO, E-Business, and International Trade. He has played leadership roles in P&L Management, Strategy, Business Development, Operations and New Business start-up. He has worked in the US, Europe and India Geographies and has managed extended sales and delivery teams in these regions.
Sandeep is currently heading Healthcare and Life Sciences (HLS) vertical at Mphasis. Mphasis (an HP Company) enables chosen customers to meet the demands of an evolving market place. Mphasis fuels this by combining superior human capital with cutting edge solutions in hyper-specialized areas. Mphasis offers Applications, Business Process Outsourcing (BPO) and Infrastructure services globally through a combination of technology knowhow, domain and process expertise. The HLS vertical at Mphasis counts large US Payers and top Global Pharmaceutical companies in its list of clients.
Sandeep has earlier worked with TCS, heading the Life Sciences business for Europe with P&L responsibility. Sandeep also headed the Outsourcing function at HP’s Global Business Services prior to working with TCS. Earlier, Sandeep led Wipro’s Healthcare BPO business across US and also managed the complete BPO portfolio for US West and Central regions.
1. Healthcare industry has been undergoing a Tsunami of changes. What are the top issues keeping payer CEO/CFO/CIOs up at night?
Sandeep Response:
The issues are majorly categorized into three segments
The Individual Mandate and emerging B2C focus – Healthcare reforms have ushered in a new business model for Payers. It has moved away from the old model of 90% of private policies being funded by employers, who negotiated prices and benefits in bulk. The advent of Health exchanges now requires the payers to negotiate with individuals and compete for their business. This new B2C focus requires a fundamental change not only in business processes and technology but also in organization culture.
Regulatory – Healthcare Reforms, Mandates from the US stimulus package, ICD, etc. are all overloadingPayers with the need to balance meeting deadlines in face of crunched bandwidth and resources. This is leading the normally conservative industry to look at new models to reduce costs and expand capacity and we see a renewed appetite for enhanced offshoring, moving T&M contracts to managed services and in evolving risk-reward models etc.
Mphasis is working with its customers on many innovative operating models to help them meet the capacity spikes needed, even while keeping fixed costs low.
Technological- To operate with a mix of legacy and new application and still make it work with an integrated architecture. To develop new consumer-marketing capabilities and consumer IT on a large scale–for instance, advanced Web capabilities, insurance exchange connectors and customer relationship management (CRM) systems; to adopt and innovate using emerging new technologies (SMAC).
2. As healthcare moves towards a retail model, what are the top strategies you see in the market place to drive consumerism?
Sandeep Response:
The new Individual retail consumer on the Market exchanges has two major expectations
- Better Quality of Healthcare service
- Reduced spending on Healthcare
With increased consumer awareness of standardized cost and pricing, the key differentiator will be service quality. Mphasis is enabling its customers for smooth onboarding of its exchange members serviced with best quality levels.
Additionally, Payers, who have focused more on B2B earlier, need to align to emerging trends in B2C marketing and sales. Payers need a mechanism to listen to their customers. Consumers will be voicing their views/concerns through different channels like Contact centers, Facebook, Twitter, Patientslikeme.com etc. Payers need a well thought, integrated consumer engagement strategy. This will help Payers address their customers quickly and efficiently.
Mphasis is helping to bring actionable insights on the market sentiments to make changes according to trending needs of customers. Mphasis also has a complete digital engagement suite under its “Customer Experience Management” services that has delivered significant value for industries like Banking and is now being deployed for the Healthcare customers.
3. In the recent past we have seen significant consolidation and M&A activity in the Payer industry, do you see the trend continuing? How will the small regional payers compete with `the large national payers in the future?
Sandeep Response:
Consolidation trend is likely to continue unless small regional payers come up with differentiated offerings even while finding ways to manage their costs better; given that the national payers have the advantage of economies of scale.
In spite of these M&As, small payers currently have two major advantages
- Outreach in regional market with specialization to meet the specific needs of customers
- Exchange Market place has actually provided them a level playing field to compete with bigger payers
The focus of small payers has to be to bring the operational cost efficiencies and still meet the MLR requirements and thus they have to look at all possible ways to increase efficiency and effectiveness of their operations
While Mphasis works with some of the large Payers, Blues and State Medicaid programs, we are also working with many regional payers through our own Payer platform like Javelin
4. IT is playing a key role in driving change in the Industry. How can organizations drive higher IT and business alignment in a dynamic business environment driven by health reform? And how do you see a service provider like Mphasis can contribute to this dynamic scenarios?
Sandeep Response:
The key considerations which payer organizations need to look at are:
- How to handle the uncertainty of reforms with less available IT budget and bandwidth of resources. Mphasis has worked with customers to bring in flexible models to quickly ramp up and ramp down of skillset during the implementations. For example during the 5010 implementation for a key customer, Mphasis worked in a factory model providing flexibility of ramp-up and ramp-down based on work volume.
- Another requirement is for a business and IT integration – Mphasis brings in expertise from both business process and applications side to support health reform needs. For example during the ICD-10 testing, Benefits setup and testing team worked hand in hand with applications team to make sure a comprehensive testing is completed for the client.
- Mphasis’ ability to interpret the trends, invest ahead of the curve and proactively build solutions/frameworks in its innovation labs, provides a significant lead time to customers to adopt changes and sail through smoothly. Mphasis as an organization has invested heavily in the SMAC technologies and is developing use cases for Healthcare in our Innovation labs with a focus on Google glass, ibeacon, wearable devices, mHealth, next generation contact center etc
- The entire Customer experience management is a big focus for Mphasis and we bring the experience and learning from other industries like banking to Healthcare.
- Overall, there is a drive within the company to align our metrics, operational models and contracts to the Business Value that we deliver to the customer, rather than just operational SLAs.
5. We see Payers have been early adopters of the outsourcing model with local and global vendors. What is your advice to Health Plan IT Executives on IT sourcing strategies?
Sandeep Response:
One of the key shifts in the outsourcing is towards managed services. Payers need to demand far more commitment from vendors towards year-on-year savings, with built in Rewards and Penalty in the contracts. The need is more for outsourcing objectives to get aligned with business goals and the next generation contracts, demand business outcomes and not just SLA adherence.
Mphasis follows a strong delivery excellence model to deliver year-on-year savings to its customers. As an example, last year Mphasis ran a LEAN program for one of the payer customers and brought 20% savings in the support budgets with many more automations which brought service quality improvements. This also helped the payers to achieve their business goals smoothly.
6. There is a lot of buzz on social media in other industries. What is your view of social media and its adoption in the payer industry?
Sandeep Response:
Social media and the entire digital marketing opportunity are playing a key role in the payer industry. Adoption has been slow earlier but trend is upwards now. There are different adoption levels by payers:
- Improved member/consumer outreach: This is the first level of adoption by one-way marketing outreach where payer organizations have their social media pages.
- New ways of customer service: This is the second level of adoption where two waycommunicationshappens with customers through social media tools.
- Understanding of Member sentiments & behaviors: This is the third level of adoption to use social media tools to do advanced analytics in customer experience management and potential crowd-sourcing.
We believe that the opportunity exists to look beyond one-way communication to making this a channel for true customer engagement and improving customer experience.
Following are some of the Customer Experience Management areas where Mphasis brings strong expertise
- Customer Insights As A Service
- Smart Information Delivery Platform
- Social Reputation Management As A Service
- Digital Factory
- Mobile Web Optimization
- Digital Supply Chain Automation
- Next Gen Contact Center
- Mobile Testing As A Service
- CRM Healthcheck
- Ubiquitious Personalization of the member’s digital experience
- Semantic Web Analytics As A Service
Mphasis has architected, designed and developed a Healthcare Portal Suite and implemented in 4 States jointly with our customer. We have already delivered customer experience management solutions in the banking space, for example we helped Fortune 500 Banks to transform from ‘Brick & Mortar’ to ‘Click & Mortar’ to ‘Omni Channel’ customer experience and this expertise is now being brought to our HLS customer also. A few examples are below:
- Digital Marketing solution for large east coast bank. Setting up a marketing eco-system that includes analytics, ad management, content management and content delivery solutions. Developed a personalization solution using customer development. The goal was to achieve finer targeting while setting up a shared digital eco-system for 78 retail applications
- Online marketing and banking portal for a large global bank. Building a shared service digital eco-system for all retail lines of business of the bank. One of the key objectives of this initiative was to revitalize the bran.
- Multichannel advisor solution for a large advisory and brokerage firm on the west coast. The solution enables advisors to provide personalized recommendation to customers based on their investment history and financial position
7. The amount of data collected seems to be exponentially increasing year over year. What do you see as the future of business analytics in the payer industry?
Sandeep Response:
Analytics have already taken a big leap from traditional reporting to predictive and stochastic techniques. Going forward, ability to leverage Analytics will be the differentiator between the average and the successful companies. While a lot has been written about the exploding data in the digital world and the need to use technology e.g. big data tools to create meaningful insights from it, equally important in our view is to look at the huge amount of internal data that payers have, that has not be leveraged fully yet. Mphasis has helped a larger payer to build a unified view of all claims, membership, provider and financial data through implementation of a new ODS and EDW that creates one source in one location maintained centrally and updated appropriately by all business users/systems.
Mphasis with its strong analytics practice is working towards some of the future needs of big data handling and visualization tools to provide better and real-time business insights to make informed decisions. This is again one of our hyper specialization areas. For example with our strong knowledge of payer/provider domain we have developed visualization dashboards for ACO’s which help them with their key decision metrics performances. Mphasis also helped a large payer to reduce the latency and load performance which was the cause of inaccurate and inconsistent information in Data Marts and Warehouses leading to wrong decisions.
Mphasis also believes that Data Management is a strategic transformational initiative for payers that if done right can help manage/minimize the cost and operational complexity that arises from managing exploding quantities of data. Mphasis has industry leading data archival solutions that allows enterprises to archive ROT [Redundant, Obsolete and Trivial data.
8. Payer industry at a large heavily uses legacy/ mainframe based applications for their core processes. Though we have seen a shift from mainframe to mid-range based application transformation, but it has been slow and steady.What are the top technology trends to watch out for in the Payer IT industry for 2014-15? In your view, how does Mphasis or other IT service providers should cope up with this transforming IT landscape?
Sandeep Response:
Payer IT landscape is continuously evolving and Mphasis has transformed itself during all these phases to support a variety of technologies for our customers.
Mphasis has been helping Payers with integration of claims platforms like Facets with the existing legacy systems, building data warehouses that pulls data from both legacy and Facets.
Though Mphasis has been supporting many payers with legacy platforms, there is defined focus on hyper specialization of key technologies to provide the solutions to the customer. The hyper specialization focus areas include Digital, Analytics and Big data, Testing, CRM, ERP, and Semantic Web.
The challenges that we are helping our customers manage are how to operate with a mix of legacy and new application and still make it work with an integrated architecture; to develop new consumer-marketing capabilities and consumer IT on a large scale–for instance, advanced Web capabilities, insurance exchange connectors and customer relationship management (CRM) systems; to adopt and innovate using emerging new technologies (SMAC).
For example in one of our payer sites we have applications ranging from MVS assembler developed in late 60’s to modern technologies like Digital, Web etc.
9. What are the top challenges Health Plan executives have to prepare for in 2014-15? As a leading IT service provider to multiple payers, how do you visualize these challenges changing over time?
Sandeep Response:
Following are the top challenges health plan executives have to prepare for, in the coming year
- Member engagement, empowerment and awareness through new channels like Mobile and digital
- Social media will become the future of current contact centers
- Advance Analytics becomes the key to business success
- Virtual health & telemedicine bring new channels of healthcare delivery with strong savings of cost
Mphasis has already invested in developing the solution for the future to be ahead in game and enable our customers to make best use of these opportunities/challenges.
10. What kind of services does Mphasis offer to the Payer Industry? Can you share a success story in a few sentences?
Sandeep Response:
Mphasis covers the entire payer value chain through its Products and Services. Some of Mphasis key payer offerings include:
- Product Development & Maintenance: Architected, Designed and developed and now supporting Mphasis products like Javelina, Wynsure and client payer product.
- Application Development & Maintenance: Managing Legacy and new technology application e.g. EDI and other integration, Data Warehousing and analytics, portals mobility, User experience etc.
- Business Process Outsourcing: Some of key processes include Benefit-plan Management, Provider, Member services and Claim administration etc.
- Infrastructure Outsourcing and Service Desk
- Specific focus on digital , social media, analytics and cloud based solutions
For example for one of our large payer customers we are handling a set of 200+ applications in all different domain areas from EDI, Core systems, Financials, BI & Analytics etc. Mphasis has been part of healthcare reform transformation and also for the integration with many third party applications like Facets, Mckesson Claim check etc.
11. Any closing thoughts you would like to share with our subscribers?
Sandeep Response:
Healthcare Industry across the world is undergoing a transformation. With increased scrutiny, regulation and reforms and the enhanced focus on outcomes, the expectation will be to deliver more with less. The need of the hour is to engage more effectively with the end customers i.e. the consumers. The solution to the above lies in leveraging technology and the right partners to ensure that the industry meets its obligations without creating a huge cost structure. The challenge in front of the industry is monumental, however the emerging technology and tools ensure that it has the armory that allows it do what it does best, i.e. improve the quality of lives of the customers by delivering the highest outcomes at a reasonable cost.