How Providers Can Reshape their Operations to Master Value-Based Reimbursements

How Providers
Can Reshape
their Operations
to Master
Value-Based
Reimbursements
Healthcare providers must make
sweeping system, process and
operational changes to thrive
under the inevitable move to
value-based payments. Here are
our recommendations on how
to get started.
Cognizant 20-20 Insights | June 2018
COGNIZANT 20-20 INSIGHTS

Cognizant 20-20 Insights
How Providers Can Reshape their Operations to Master Value-Based Reimbursements | 2
Executive Summary
The healthcare industry’s transition to value-
based payments has been slow but steady;
inevitably, this new compensation approach
will supplant existing fee-for-service models.
The Centers for Medicare & Medicaid Services
(CMS) has set a target of making 50% of its
reimbursements through value-based care
programs by the end of 2018.1
The transition is being hastened by the entry of
new healthcare players and increased consumer
financial accountability, both of which are serv-
ing to disrupt and compress the healthcare value
chain, and pressuring providers to adopt val-
ue-based reimbursement.
Yet adopting value-based payments is challenging
for providers because their clinical and financial
systems, processes and quality metrics were
built to support the industry’s traditional fee-for-
service model. Providers moving to a value-based
world must retool systems and gain new skills and
capabilities, as industry players and regulators
settle on universally acceptable quality metrics
that are consumer-driven. Accomplishing
these formidable tasks will reshape not just
how providers deliver care but also how the
entire industry determines the value of patient
outcomes.
Providers must start investing in value-based
care capabilities to remain relevant as industry
disruption continues. Simultaneously, they must
continue optimizing revenue cycle management,
enhancing quality of care and enabling greater
patient accountability for success as the industry
mixes fee-for-service and value-based care.
This white paper discusses the forces making
the shift to value-based payments inevitable, the
challenges providers must overcome and how
they can realistically improve their readiness to
operate in a value-driven health industry.
VALUE-BASED
REIMBURSEMENTS:
READY OR NOT, THEY’RE COMING
Most of healthcare is still delivered on a fee-for-
service basis, with every provider, lab, specialist
and clinical service appearing as a separate line
item on the insurer’s explanation of benefits.
Underlying provider-payer contracts determine
actual reimbursements for services rendered,
making it difficult-to-impossible for patients to
get clear answers upfront about their ultimate
financial responsibility, let alone comparison-
shop for services.
Yet the industry is steadily moving toward a
consumer-driven value chain, one in which tech-
nological advances, ubiquitous smart devices,
wearables and the Internet of Things (IoT) enable
more care to be delivered directly to consumers
via on-demand healthcare platforms that enable
patients to pick and choose their medical provid-
ers based on price and value.
2
Adopting value-based payments is
challenging for providers because their
clinical and financial systems, processes and
quality metrics were built to support the
industry’s traditional fee-for-service model.

In a consumer-centric industry, pricing transpar-
ency is critical,
3
and quality will be measured in
outcomes – specifically, outcomes important to
consumers and patients. Our recent study, con-
ducted with our partner ReD Associates, shows
that consumers and patients use different
approaches to measuring provider quality from
the clinical numbers and procedural measures
that drive typical provider quality metrics (see
Quick Take, below).
4
QUICK TAKE
Quality Outcomes from the
Patient’s Perspective
Under value-based care, patients will have louder voices on whether a
provider has delivered quality care and an outcome that meets their expec-
tations and needs. While meaningful clinical metrics, rigorously followed
protocols and high adherence rates are standard quality metrics for provid-
ers, these are not likely to be of greatest concern to patients.
That’s a key finding of our recent study, conducted with our partner ReD
Associates.5
This ethnographic field study, supported by a large quantitative
phone survey, indicates that more than 85% of patients don’t find quantifi-
able clinical numbers to be very relevant to their healing journeys. Further,
many respondents said that even while they closely follow a treatment plan,
they don’t feel as though they’re healing.
The leading indicator that patients use to evaluate their healing experience
is whether they can do what’s important to them. Our research showed
patients judge the quality of their healing by how well they can carry out
their life goals, from playing soccer to visiting their grandchildren. We also
found that patients go to great lengths to manage their care, in their own
way, to achieve these personal goals. Patients experiment with medication
dosages and timings, seek advice from peers, and generally work to fit their
care into their existing lifestyles.

To earn high marks under this patient-centric quality measure, providers
must:
• Help patients establish and track meaningful life goals. By correlat-
ing patient goals with underlying clinical metrics, providers gather useful
data while supporting patient efforts.
• Guide patients through their treatment protocols. Providers must help
patients adapt therapies to their needs rather than promoting one-size-
fits-all patient treatment journeys.
• Provide personalized, context-based follow-up care. Such care must
empower patients to make their own decisions based on their lifestyles,
support systems, goals and resources.
Aligning value-based care with patient-defined metrics is a win for all. Our
study indicates that patients who feel they are at the center of their care
are more likely to adopt healthier behaviors. When properly designed, digital
tools can “warm up” healthcare delivery by giving patients real choices and
more personal control. These qualities should encourage behaviors that can
lead to better outcomes – the key goal of value-based care.

Basing reimbursements on outcomes will require
providers – and the industry – to adopt new
definitions of quality and ways of measuring
it; new financial systems and techniques that
support value-based financial modeling; and a
new approach to care delivery that is based on
wellness, continuous monitoring and preventive,
proactive interventions for an entire population
vs. managing only those chronically at risk.
The grand vision is clear, and the federal govern-
ment has adopted legislation and regulations to
create incentives for providers to shift toward
value-based payments (see Figure 1). Yet prog-
ress has generally been slow.
In a nationwide survey of 346 hospital executives,
only 14.1% of respondents said their payments
were currently tied to value as defined by CMS
and that just under 7% of their revenue was truly
at risk. Participation in value-based payment
programs was highest in the largest hospitals
(200-plus beds).
6
Regardless of provider participation, market
forcesaresteadilypushingvalue-basedcareadop-
tion (see Figure 2 , next page). That’s reflected in
value-based care reimbursement percentages
reported by two of the nation’s largest private
payers in 2017: United Healthcare Group, with
45%, and Aetna, with 40%.
7
Further, new entrants like the proposed Amazon-
Berkshire Hathaway-Chase healthcare entity,
8
the
planned acquisition of Express Scripts by Cigna
9
and the partnership talks between Walmart and
Humana
10
are ultimately about gaining control
of the care delivery process, driving down costs
and improving the customer experience. Provid-
ers that want to remain competitive in the rapidly
evolving healthcare economy must deal now with
the demands of adopting value-based care.
CMS: Driving Value-Based Payment Programs
Federal legislation has been prodding the industry to move toward value-based programs for nearly a decade.
These regulatory efforts are laying the groundwork for wider adoption of value-based reimbursements by
private payers.
LEGISLATION & PROGRAM
MIPPA: Medicare Improvements for Patients & Providers Act
• ESRD-QIP: End-Stage Renal Disease Quality Incentive Program
ACA: Affordable Care Act
• HVBP: Hospital Value-Based Purchasing Program
• HRRP: Hospital Readmission Reduction Program
• HACRP: Hospital-Acquired Condition Reduction Program
• VM: Value Modifier or Physician Value Based Modifier (PVBM)
LEGISLATION & PROGRAM
PAMA: Protecting Access to Medicare Act
• SNF-VBP: Skilled Nursing Facility Value-Based Purchasing Program
MACRA: Medicare Access & CHIP Reauthorization Act of 2015
• APMs: Alternative Payment Methods
• MIPS: Merit-Based Incentive Payment System
*Data collection for APM and MIPS began in 2018.
LEGISLATION
PASSED
PROGRAMS
IMPLEMENTED
MIPPA ACA PAMA MACRA
ESRD-QIP
HVBP
HRRP
HACRP VM SNF-VBP
*APMs
*MIPS
2008 2010 2012 2014 2015 2018 2019
Figure 1
Source: CMS, https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/Value-Based-Programs.html.

A CHALLENGING TRANSITION
Value-based payments can’t simply be overlaid on
existing operational infrastructure and business
processes. Successful adoption that captures real
value will require providers to restructure their
business, operating and technology models. This
raises four primary challenges:
11
• Infrastructure and technology. Electronic
health record (EHR) rollouts have consumed
a large share of investment resources so
far; investments must now be redirected to
new system-wide patient care and financial
capabilities rather than restricted, unco-
ordinated, departmental implementations.
Providers must expedite their efforts to fill
care management roles despite the difficulty
of finding people experienced in value-based
care delivery.
• Business operations and personnel. Popu-
lation health management under value-based
care requires a significant investment in work-
force and tools; the challenge here is that
payer metrics and incentives are not uniform
across the industry, making it difficult for pro-
viders to know where to focus their resources
for the greatest gain. In addition, while val-
ue-based care is all about quality metrics,
many physicians find quality reporting to
be burdensome. Providers need to adopt
new and seamless reporting experiences for
clinicians to ensure they capture critical data
at the point-of-care that enable the reporting
and analytics required for value-based reim-
bursement.
• Performance measurement. In part because
of the lack of industry consensus, providers
are finding it difficult to define quality
Public and Private Payers Vow to Increase Adoption of Value-Based Programs
CMS and the Health Care Transformation Task Force (made up of payers, providers and other industry
stakeholders) plan to increase payments through value-based programs.
0%
10%
20%
30%
40%
50%
60%
CMS
0%
10%
20%
30%
40%
50%
60%
70%
80%
Health Care
Transformation Task Force
2017 Target 20202017 Target 2020
Figure 2
Sources: CMS.gov (https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2016-Fact-sheets-items/2016-03-03-2.html)
and Healthcare Transformation Task Force (https://hcttf.org/about-us/).

metrics. Most providers are also not yet
adept at crunching claims and operational
data to better model and understand the
financial risk they would assume under
value-based care. In addition, current
hospital cost accounting capabilities can’t
accurately determine actual costs of care
(vs. reimbursable amounts), a key variable
in succeeding with value-based contracts.
Finally, only 5% to 10% of physician pay is
tied to value;
12
it is possible physicians will
take on more risk if rewards are bigger.
• Market forces. Payer contracting varies
by market and payer type, i.e., commercial,
federal or state. The inconsistencies make
it difficult for providers to develop an over-
arching value-based strategy and achieve
a critical mass of patients in each of the
value-based programs.
Internally, most providers encounter cultural
as well as process difficulties when trying to
better coordinate care across a variety of pro-
vider settings. Extensive training and change
management programs are needed to address
these issues.
Current hospital cost accounting capabilities
can’t accurately determine actual costs
of care (vs. reimbursable amounts), a key
variable in succeeding with value-based
contracts.
Value-based payments can’t simply be
overlaid on existing operational infrastructure
and business processes. Successful adoption
that captures real value will require providers
to restructure their business, operating and
technology models.

THE ROADMAP TO
VALUE-BASED PAYMENT
Despite these challenges, three key levers will
increase providers’ ability to deliver quality (as
desired by patients), reduce costs and improve
performance.
• New lower-cost, higher-tech medical inter-
ventions: Patient monitoring will shift from
impersonal, episodic and chronic condi-
tion-based to a personalized, continuous and
noninvasive paradigm through wearables, apps,
smart devices, in-home equipment and AI and
intelligent machines that predict issues. Exam-
ples include alerting a patient and physician to
the conditions that signal a pre-diabetic state,
or markers indicating rising cholesterol levels
before that shows up on a blood test. Individuals
will confer with physicians and multidisciplinary
teams about interventions via telemedicine
and interactive apps. Such capabilities will help
providers build and manage long-term rela-
tionships with a much larger population while
keeping patients out of high-cost care settings.
• Future measures of quality performance:
We expect the healthcare industry to estab-
lish at least 60% of its measures on clinical
data and patient-reported outcomes within
the next decade. CMS is again an industry
driver: It recently announced its Meaningful
Measures program, one focus of which is to
measure more outcomes defined by patients.
13
An industry move toward commonly defined
outcomes will help providers know which data
to capture and should enable standard solu-
tions and tools to do so.
Capturing this data will require scalable and
robust reporting frameworks and enterprise-
wide analytics to proactively identify oppor-
tunities and close reporting and satisfaction
gaps. To align clinical and outcome measures
with payment, providers will need to inte-
grate electronic health records with billing,
cost accounting, administrative and vendor
applications – a largely untested area. Paying
physicians and other clinical service providers
not directly employed by the provider under a
value-based model could create administrative
bottlenecks if systems for automated disburse-
ment to the concerned providers (based on
their individual contracts) are not aligned.
• Future healthcare regulatory framework:
With Medicare and Medicaid under constant
financial pressure, it is likely CMS and the
federal government will develop policies and
programs requiring providers to take on more
risk-sharing and performance penalties.
14
To prepare, providers must track payer con-
tracts and government healthcare mandates
that affect their volumes and revenues, mon-
itor their direct competitors’ performance,
and assess their own performance against
industry benchmarks for operating margins,
current ratio, best practices, etc.
Additional steps to prepare for future value-
based participation include:
To align clinical and outcome measures
with payment, providers will need to
integrate electronic health records with
billing, cost accounting, administrative
and vendor applications.

»» Embracing consumerism, through pricing
transparency, publishing clear prices for
cash-pay individuals and participating in
emerging on-demand health platforms.
»» Tracking physician performance and effec-
tiveness.
»» Monitoring current and projected clinical
performance measures and their impact
on financial performance.
Structure and investments will change as value-
based payments become the preferred industry
business model. Investments in electronic health
records implementations will evolve toward
implementation of population health manage-
ment tools. Revenue cycle management designed
for fee-for-service payments will give way to
pricing transparency, mobile health platforms,
patient engagement and greater consumer
empowerment. Data analytics and reporting will
move out of departmental silos and drive greater
efficiency through leveraging cost accounting
and automation.
Finally, while fee-for-service business models
drive consolidation among providers, value-based
care models will open the door to providers
partnering with – and potentially receiving invest-
ments from – nontraditional industry players.
NEXT STEPS TOWARD
VALUE-BASED PAYMENTS
Providers must begin the journey toward val-
ue-based payments by extensively evaluating the
maturity of their operational areas that are essen-
tial to the successful delivery of value-based care
(Figure 3, next page, and Quick Take, page 11).
Providers should evaluate their capabilities and
practices across these four dimensions:
Care Provision
Care provision involves population health man-
agement, patient engagement and coordination
of clinical care delivery. Key assessment ques-
tions include:
• When managing a patient’s care, is it a top
priority to consider socioeconomic criteria
and collaboration with community-based
resources, such as housing organizations and
social workers?
• Does easy and secure messaging exist
between providers and patients?
• Is there a care transition plan with clear next
steps for patients being discharged?
• Are patient education resources tailored for
specific diagnoses and/or symptoms?
Finally, while fee-for-service business
models drive consolidation among
providers, value-based care models will
open the door to providers partnering
with – and potentially receiving
investments from – nontraditional
industry players.

Financial Management
Tracking and managing the cost of care is critical
in a value-based model. Key evaluation priorities
include:
• Comfort with risk-based contracting models.
• Internal processes to identify and manage the
costs of services and procedures.
• Clarity on physician performance measure-
ments.
Health Information Technology
Sound health information technology systems
document and share data among a caregiving
team. They deliver levels of care based on pop-
ulation risk stratification. Key questions here
include:
• Can our primary care and behavioral health
staff document observations and treatments
in a shared medical health record to coordi-
nate care delivery?
• Does our care plan platform integrate details
from claims and other operational systems?
• Do we use tools to perform predictive or com-
parative analytics using clinical and/or claims
data?
Evaluating Maturity for Value-Based Reimbursement
Successfully adopting value-based care requires providers to fundamentally restructure information technology,
financial management and care delivery. Comprehensive change management efforts and internal leadership
must support these efforts and build acceptance of new measures of success.
Integrated information
technology platform
Siloed Information Technology
systems for functions,
services and departments
Measure process for
compliance and charges
Fee for service payments
based on volume
Measure outcomes and
cost for each patient
Move to bundled payments for
care cycles
CARE
PROVISION
FINANCIAL
MANAGEMENTINFORMATION
TECHNOLOGY
HEALTH
ORGANIZATIONALALIGNMENT
AUTOMATION
Low Maturity High Maturity
EVALUATING MATURITY FOR VALUE-BASED REIMBURSEMENT
Integrate care delivery systems
Each hospital offers
a full line of services
Change Adoption
Cultural Shift
Clinical Champions
Communications
Figure 3

Organizational Alignment
Adopting value-based reimbursements requires
a huge organizational shift that must be fully
scoped and well managed, with a clear roadmap
and realistic milestones. Key questions to gauge
change readiness include:
• Do we have the necessary change manage-
ment capabilities to carry out the necessary
enterprise transformation?
• Do we have leadership support for the cul-
tural changes that will be necessary to make
the transition to value-based payments?
• Have we identified physician, nursing and cli-
nician champions for value-based payment
initiatives?
• Are we doing our best to communicate our
value-based payments vision to our staff and
its importance to our future?
These are just a sampling of the capabilities pro-
viders must assess to evaluate their cultural and
structural readiness for value-based payments.
With these insights, providers can define what
operational maturity looks like in their unique
settings. That definition becomes the lodestone
for cost-benefit analyses that determine whether
to improve current programs and/or implement
new initiatives and set priorities and timeframes
for doing so.
QUICK TAKE
Taking a Multidimensional Approach to
Assessing Readiness for Value-Based Payments
Adopting value-based payments will require more than a next-generation financial
system, as this shift affects nearly every operational function of a healthcare system.
Organizations must understand the extent of its impact across multiple dimensions and
how these changes will help or hinder their adoption of outcome-based reimbursements.
These insights are critical to developing a realistic roadmap and actions necessary to
create the required future state.
Our value-based payments maturity evaluation methodology assesses these key areas:
• Strategy: How value-based payments and an organization’s short- and long-term
business objectives and strategies may complement each other or create obstacles.
• Operations: The state and maturity of business operations as they relate to processing
value-based reimbursements, including data gathering, workflows, care delivery, etc.

• Technology: The existing infrastructure’s flexibility and the application
portfolio capabilities.
• Organizational culture: The cultural impact of value-based payments
and the required change management initiatives.
We then utilize a dedicated team of subject matter experts and custom
methodology to conduct an assessment, which encompasses:
• Responses from a customized survey using a bank of curated questions.
• One-on-one interviews with management team members.
• Shadowing and ethnographic studies with operation team members.
The maturity score is based on the quantitative analysis from the survey and
operational metrics, combined with the qualitative input from the interviews.
In addition to determining the current maturity of the organization with
respect to value-based payments, the evaluation also does the following:
• Helps organizations identify their strengths and weaknesses across
the 30 categories evaluated.
• Establishes synergies that are advantageous in both a fee-for-service
model and value-based payments model and prioritizes them during the
transitional phase (e.g., implementing care services that are critical for
value-based payments that also generate better outcomes under the fee-
for-service model).
• Acts as a beacon to reassess implementation programs in light of their
effects on the value-based payments maturity score.

What’s critical is to get started right away. Provid-
ers now compete with Amazon and Walmart, not
just the healthcare systems across town. Taking
the necessary steps to transition to value-based
payments will equip providers with streamlined,
consumer-focused systems, processes and capa-
bilities. With that foundation, providers will be
positioned to adopt disruptive new business
models of their own, as well as participate in
healthcare on-demand platforms and new part-
nerships that are reshaping the industry.
Providers now compete with Amazon and
Walmart, not just the healthcare systems
across town. Taking the necessary steps to
transition to value-based payments will equip
providers with streamlined, consumer-focused
systems, processes and capabilities.

FOOTNOTES
1 “Better Care, Smarter Spending, Healthier People: Improving Quality and Paying for What Works,” CMS, March 3, 2016,
https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2016-Fact-sheets-items/2016-03-03-2.html.
2 William “Bill” Shea and Patricia Birch, “Rethinking Health Plan Business Models for The Emerging On-Demand Digital
Economy,” Cognizant Technology Solutions, August 2017, https://www.cognizant.com/whitepapers/rethinking-health-plan-
business-models-or-the-emerging-on-demand-digital-economy-codex2846.pdf.
3 “Transparent Pricing: The Future for Healthcare Providers,” Cognizant Technology Solutions, April 2017, https://www.cogni-
zant.com/whitepapers/transparent-pricing-the-future-for-healthcare-providers-codex2723.pdf.
4 Mikkel Brok-Kristensen, Sashi Padarthy, Charlotte Vansgaard, Cary Oshima, “Helping People Heal,” Cognizant Technology
Solutions and ReD Associates, 2017, https://www.cognizant.com/whitepapers/helping-people-heal-codex2829.pdf.
5 Ibid.
6 “Transforming Healthcare to a Value-Based Payment System,” Washington Post and Philips, http://www.washingtonpost.com/
sf/brand-connect/philips/transforming-healthcare/.
7 “UnitedHealth, Aetna, Anthem Near 50% Value-Based Care Spending,” Forbes, Feb. 2, 2017, https://www.forbes.com/sites/
brucejapsen/2017/02/02/unitedhealth-aetna-anthem-near-50-value-based-care-spending/#232f51a11d4e.
8 William Shea, “Amazon Partners Up to Disrupt Healthcare,” Digitally Cognizant, Feb. 8, 2018, https://digitally.cognizant.com/
amazon-partners-up-to-disrupt-healthcare-codex3423/.
9 Jodie Thellin Skyberg, “Cigna & Express Scripts: Yet Another Sign of a Healthcare Value Chain Shakeup,” Digitally Cognizant,
March 13, 2018, https://digitally.cognizant.com/cignas-proposed-express-scripts-takeover-another-sign-healthcares-emerging-
smarter-tighter-value-chain-codex3533/.
10 Patricia Birch, “How a Walmart, Humana Tie-Up Would Accelerate Disruption of the Healthcare Value Chain,” Digitally
Cognizant, April 6, 2018, https://digitally.cognizant.com/walmart-humana-tie-up-accelerate-disruption-healthcare-val-
ue-chain-codex3580/.
11 “The Transformation to Value: A Leadership Guide,” Healthcare Transformation Task Force, Sept. 13, 2017, https://hcttf.
org/2017-9-13-the-transformation-to-value-a-leadership-guide.
12 Rich Daly, “Little Value-Based Pay for Physicians,” Healthcare Transformation Task Force, Nov. 2, 2017, https://www.hfma.org/
Content.aspx?id=50671.
13 “Meaningful Measures Hub,” CMS, https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Qual-
ityInitiativesGenInfo/MMF/General-info-Sub-Page.html.
14 “MACRA: Marching Healthcare Toward Value-Based Care (Part 1),” Cognizant Technology Solutions, Aug. 10, 2018, https://
www.cognizant.com/perspectives/macra-marching-healthcare-toward-value-based-care-part1.

Srivaths Srinivasan
Director, Cognizant Consulting
Provider Practice
Ruchi Mishra
Manager, Cognizant
Consulting Provider Practice
Vivek Joseph
Consultant, Cognizant
Arnab Biswas
Consultant, Cognizant
Anang Srinivas
Senior Consultant, Cognizant
Srivaths Srinivasan is a Director within Cognizant Consulting’s Pro-
vider Practice and leads the group’s Revenue Cycle Management
(RCM) sub-practice. He has prior professional experience in health-
care operations and management consulting. Srinivath’s expertise
covers the healthcare continuum in both the provider/payer mar-
kets and RCM business operations. He can be reached at Srivaths.
Srinivasan@cognizant.com.
Ruchi Mishra is a Manager within Cognizant Consulting’s Provider
Practice and is the operations lead for the Revenue Cycle Man-
agement (RCM) service line. She has deep RCM expertise across
hospitals, retail pharmacies and DME providers. Her healthcare
expertise includes providers, payers, pharmacy benefit manag-
ers (PBMs) and retail pharmacies. She can be reached at Ruchi.
Mishra2@cognizant.com.
VivekJosephisaConsultantwithinCognizantConsulting’sProvider
Practice. He has experience in advisory services and healthcare
data analytics and has worked extensively in the Medicare and
Medicaid markets. His expertise includes care management, CMS
audits, vendor data integration and RCM business operations. He
can be reached at Vivek-3.jJseph-3@cognizant.com.
Arnab Biswas is a Consultant within Cognizant Consulting’s Health-
care Practice and is a leading member of the RCM service line.
With his exposure to healthcare payers, provider business pro-
cesses and background in technology services, Arnab is passionate
about helping clients overcome business challenges and improving
healthcare through technological innovation. He can be reached at
Arnab.Biswas3@cognizant.com.
Anang Srinivas is a Senior Consultant with Cognizant Consulting’s
Provider Practice. He has professional experience in healthcare
informatics and management consulting. His expertise includes
the provider and payer markets, and clinical and financial
analytics. He can be reached at Anang.Srinivas@cognizant.com.
ABOUT THE AUTHORS
The authors would like to acknowledge Rachelle Alpern, Senior Innovation Consultant, Center for
Innovation, UNC Healthcare, for her valuable insights and contributions to this white paper.
ACKNOWLEDGMENTS

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industry’s most pressing IT and business challenges — from rethinking new business models, to optimizing operations and enabling technol-
ogy innovation. A global leader in healthcare, our industry-specific services and solutions support leading payers, providers and pharmacy
benefit managers worldwide. For more information, visit www.cognizant.com/healthcare.
ABOUT COGNIZANT
Cognizant (Nasdaq-100: CTSH) is one of the world’s leading professional services companies, transforming clients’ business, operating and
technology models for the digital era. Our unique industry-based, consultative approach helps clients envision, build and run more innovative
and efficient businesses. Headquartered in the U.S., Cognizant is ranked 195 on the Fortune 500 and is consistently listed among the most
admired companies in the world. Learn how Cognizant helps clients lead with digital at www.cognizant.com or follow us @Cognizant.

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