Headstrong Launches Flexible Service Oriented Architecture Framework for Healthcare Payers

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Leading global IT consultancy’s newest service offering enables payers to respond effectively and efficiently to Health Insurance Exchanges resulting from latest reforms.

Headstrong, a leading global financial services and healthcare consultancy, today announced the release of a new service offering which enables payers to respond to the impending arrival of Health Insurance Exchanges. Payers will be able to assess the readiness of their product, quoting, underwriting, actuarial, enrollment and membership systems through the new service offering’s Insurance Exchange service-oriented architecture (SOA) Connectivity, Product Lifestyle Management and Cycle Time Optimization components.

Healthcare reform, specifically the Patient Protection and Accountable Care Act, mandates the use of state government-based exchanges to sell health insurance to individuals and small businesses with less than 50 employees. To successfully enable this model, payers must ensure their quoting, underwriting, rating and membership systems integrate with the relevant exchanges in their markets. This presents payers with a significant amount of complexity when deciding how to connect effectively to multiple state government-based exchanges.

“Traditionally, the business functions of quoting, product development, underwriting and actuarial have been black boxes inside a payer’s organization. So far this has worked, but in the new reality, a payer’s sales and marketing systems must be transparent and provide instant value to a number of external stakeholders,” said Vinay Nadig, principal of Headstrong’s Healthcare Practice. “To enable such transparency and value, Headstrong’s service offering takes a ‘transform while we perform’ approach, layering a service oriented framework on top of legacy systems to accelerate the ability to connect and expose relevant functionality.”

The SOA framework focuses on several key areas within payers’ internal systems, more specifically:

  •     Product and benefit enquiry services to expose catalogued product and benefit information
  •     Rating services to implement logic to accommodate Patient Protection and Affordable Care Act (PPACA) mandates
  •     Quoting services to enable the purchase of health insurance through exchanges
  •     Membership services to facilitate the enrollment of members through exchanges
  •     A Business Process Management (BPM) automation framework to link disparate departments involved in product development; shorten the time required to implement and/or setup new products and product changes; allow for the reduction/elimination of quality issues, as well as cycle time reduction for account installation

Headstrong’s service-oriented architecture framework is currently assisting of the nation’s largest health insurers respond to the impending health insurance exchanges. Headstrong is using its new service offering to realign the client’s legacy systems around product, rating and quoting to a set of business services that can be consumed by the exchanges, or any other consumer portal.

About Headstrong
Headstrong is a global consulting and IT services company with a specialized focus in financial and healthcare services. With three decades of domain expertise, Headstrong is the world’s leading offshore outsourcing company for the capital markets and securities industry, industry and is sharing similar success within the payer and PBM industries.

Headstrong delivers targeted domain solutions and a full complement of services, from strategy and business consulting to technology and operations, using multi-shore resources and global project management ools, methods and standrds. Headstrong maintains operations in seven countries, including offshore centers in India and Manila, with more than 3,500 employees globally.

“Headstrong” is a registered trademark of Headstrong Corporation in jurisdictions throughout the world. All other company and product names may be trade names or trademarks of their respective owners.

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Kerry McFadden
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