Digital TPAs are investing significantly in creating useful insights and analytics models to benchmark and enhance their administration platforms. In turn, this provides improved decision-making at the time of underwriting and better or more accurate claims reserving.

Third-party administrators (TPAs) have long enabled insurance companies to focus on their core business strategies and drive non-strategic blocks of business without compromising on customer service and financial objectives.

However, new digital business models are forcing insurance companies to leverage Digital across their customer touchpoints, creating a huge data footprint. Information mined from this data can generate tremendous value to insurance companies, enabling them to improve their business strategies and create competitive differentiation.

While traditional TPAs currently exchange a huge amount of service data with insurance companies, they seldom use this data to exceed service delivery metrics or provide value-added services to their customers. Digital TPAs, however, focus this data exchange on delivering enhanced insights over and above the standard reporting of traditional TPAs—adapting to become a major contributor of value.

To this end, here are some of the key tenets of how TPAs are driving their transition from simply providing a reporting function to delivering actionable insights for enhanced decision-making:

Develop data acquisition capabilities around key KPIs—developing KPIs around call center, policy, claim, billing and payment data and developing a robust KPI metric is an important first step. More importantly, this should complement analytics that insurers are doing at their end to result in improved revenue management and accurate claims reserving.

  • Simplify data architecture to focus on data enrichment and availability—Digital TPAs enrich data assets during service transition, becoming a strategic value creation opportunity. Enriching and uncluttering existing data assets, as well as the easy accessibility and availability of this data, enables Digital TPAs to further unlock value.
  • Blend data with insurer’s analytic appliances—Digital TPAs need to ensure the integrity of data and a single version of truth across multiple touchpoints, through which data is delivered. It is important for TPAs to bring this consistency and integrity across the data they share with their clients and deliver consistent analytics.
  • Backward link analytics to TPAs operating processes—Digital TPAs create cross linkage to improve KPI performance and deliver enhanced operational productivity through a strong analytic platform that establishes a relationship between workflow processes and KPIs using granular process data.

To summarize, Digital TPAs can deliver increased value by leveraging data assets, creating an analytic appliance and establishing a smooth flow of analytics to an insurer’s operations to mutualize the value that data can deliver.

The next progression in value discovery is enabling self-service capabilities by leveraging visualization technologies within their core operations and across boundaries to their customers. This is an opportunity for Digital TPAs to create value beyond simple cost arbitrage.

To learn more about how our IBAS solution can deliver useful insights and analytical models to benchmark and enhance your administration platforms for improved decision-making, contact: umesh.chandorkar@capgemini.com

Click here to learn more about how Capgemini’s Integrated Business Administration Services (IBAS) provides an integrated technology and operations platform for Life and Health insurers in the North American market.

Click the links to read the other blogs in this series:

Six Reasons Why Digital TPAs Will Disrupt the Traditional TPA Industry

How Digital TPAs Can Enhance Your Digital Customer Engagement

How Digital TPAs Deliver Faster Growth for Insurance Companies Through “No Regret” Product Launches

Leveraging a Digital TPA to Eliminate Paper Delivers Benefits across Your Insurance Company

Conversions vs. Technical Wrappers—Bridging the Gap