March 2024

New technology. A pandemic. Inflation. A tough labor market. We are all constantly trying to keep pace with today’s world and find innovative ways to enhance products and services, streamline operations and increase engagement and retention among our employees. It’s no wonder employers and employees alike are feeling stretched too thin.

Health benefits are one of the most important investments employers make. If you’re feeling the squeeze of trying to balance rising costs with the need to enhance health benefits, business process outsourcing can be a cost-effective option.

What is business process outsourcing?

Business process outsourcing – also sometimes called private-labeling or white-labeling – employee benefits services involves outsourcing specific functions to a third-party provider like a Third-Party Administrator (TPA) and rebranding those services as if they were developed and operated in-house. A TPA offers administrative support for businesses with self-funded health plans. But some TPAs, like Nova, can do much more. Collaborating with a TPA provides access to a pool of specialized professionals with in-depth knowledge of health benefits services including claims administration, care navigation and medical management – which can be outsourced or private-labeled.

Why would an organization choose to outsource their health plan administration services?

Here are a few good reasons:

1. Expertise and Specialization: Third-party providers such as a TPA specialize in specific areas of employee benefits, such as claims administration, care navigation, case management or wellness programs. Outsourcing some or all of these services allows organizations to leverage the expertise of these specialists without having to develop the knowledge internally.
2. Cost Efficiency: Developing and maintaining the infrastructure and technology needed for comprehensive employee benefits services can be costly. Business process outsourcing allows your organization to benefit from existing infrastructure, reducing capital and operational expenditures.
3. Focus on Core Competencies: By outsourcing specific health plan services, your organization can concentrate on its core business functions. This can enhance efficiency, productivity, and innovation in areas that directly contribute to your organization’s mission and objectives.
4. Time Savings: Private-labeled services often come with pre-established systems and processes. This can expedite the implementation of employee benefits programs, ensuring a quicker rollout and, consequently, faster benefits realization for employees.
5. Access to Advanced Technology: TPAs frequently invest in cutting-edge technologies and tools to stay competitive. This means you can access and integrate these advanced solutions without the need for substantial in-house development.
6. Scalability: Organizations experiencing fluctuations in workforce size or those planning for growth may find business process outsourcing advantageous. A TPA can offer scalable solutions that easily adapt to changing organizational needs.
7. Enhanced Employee Experience: You may be able to offer a broader range of employee benefits and services, improving the overall employee experience. This can contribute to improved employee health, satisfaction and retention.
8. Cost Transparency: You will likely have a transparent cost structure for any employee benefits services you outsource, making it easier to budget and plan for health benefits expenditures without hidden or unexpected costs.

Let’s take a closer look at the most common services a business might outsource:

• Medical Management: Outsourcing medical management services enables businesses to enhance the quality of health care solutions for their clients. From coordinating care plans to optimizing medical resources, a TPA can offer a range of services that cater to the diverse needs of individuals and organizations.
• Care Navigation: Navigating the complex health care landscape is a challenge for everyone. With the support of a TPA, companies can offer personalized care navigation services, ensuring that individuals receive the right care at the right time, ultimately improving health outcomes.
• Claims Administration: Efficient claims administration is crucial for the smooth functioning of any health care-related service. Partnering with a TPA for private-labeled claims administration services helps companies minimize errors, reduce processing times, and enhance overall customer satisfaction.
• Data Analysis: In the era of big data, harnessing the power of analytics is paramount. TPAs equipped with advanced data analysis capabilities can help businesses extract actionable insights, enabling them to make informed decisions, improve service delivery, and stay ahead in a competitive market.

In summary, outsourcing employee benefits services can be a strategic move for organizations looking to enhance the quality and efficiency of their offerings while maintaining a focus on their core competencies and optimizing costs.

With an experienced team of skilled and seasoned professionals, Nova has the flexibility to white-label a variety of health plan administration services. Learn more about how we can help.