Actuarial and Financial

The Massachusetts eHealth Collaborative (MAeHC) has partnered with Cognizant for Domain 1, Actuarial and Financial support. Cognizant is one of the world's leading professional services companies, transforming clients' business, operating and technology models for the digital era. Their industry-based, consultative approach helps clients envision, build and run more innovative and efficient businesses. Cognizant has worked with numerous clients in the value-based care (VBC) payment domain and has been associated in different capacity to mitigate the gap for the clients.

Our approach will leverage Cognizant’s healthcare domain experience to accelerate client innovation, gain insights and fuel ideation for customer experience redesign of the identified future capabilities. Redesign “through the eyes of the customer” will be the primary guiding principle in the process. Our approach will use industry best practices to decompose the requirements into functional and non-functional requirements with greater inclusion of downstream teams to reduce rework.  

Example Project:

MAeHC and its partner Cognizant can help initiate the transition from standard to risk-based reimbursement models by helping to define and develop key bundle payment areas, and support the implementation management and training based on the Bundled Payments for Care Improvement model.

Our team can assist by interviewing leaders across multiple areas to understand current state activities, capabilities, challenges and needs. We can chart the current process flow identifying the current set of people, process, technology components of Population Health Management and Care Management components and identify the capability requirements to move to a risk-based payment model. As needed, we can provide advanced technology advisory and business consulting services for a care management or Population Health Management platform selection and implementation. This may include current state assessment to understand ACO program requirements and gaps, process mapping to identify care navigator role, data maps, and bottlenecks in various settings and business requirements to identify, prioritize and support organization needs. Vendor selection and evaluation tools can be shared to identify suitable products. Potential key activities and deliverables are outlined below: