tcs healthcare presentation 05 07 09
DESCRIPTION
Virtual Trade Mission: Exploring Opportunities in India May 7, 2009TRANSCRIPT
TCS ConfidentialApril 12, 2023
TCS Healthcare PresentationPresented at Nashville India Virtual Trade MissionMay 7, 2009
Industry Trend -- BCBSA MandateA Plan to Improve Health Care and Limit Costs A Plan to Improve Health Care and Limit Costs
Interview with Scott Serota - President and Chief Executive BCBS Association
New York Times – Oct 17 2008
Interview with Scott Serota - President and Chief Executive BCBS Association
New York Times – Oct 17 2008
• Cut prevalence of diabetes in half
• More affordable healthcare
• Get waste out of the system
• Stop paying hospitals to treat patients harmed by care
• Healthcare coverage for everyone
• Cut prevalence of diabetes in half
• More affordable healthcare
• Get waste out of the system
• Stop paying hospitals to treat patients harmed by care
• Healthcare coverage for everyone
How can TCS facilitate you - Wellpoint’s CIO and IT organization assist in achieving some of these goals
How can TCS facilitate you - Wellpoint’s CIO and IT organization assist in achieving some of these goals
• Group Admin• Enrollment• Other Group
and Member Processes
• Member Services
• Analytics•Care Mgmt•Disease Mgmt•Wellness Prog.•Underwriting•Risk Mgmt•Accumulators•Denial Mgmt•Fraud and Abuse
•Provider Mgmt•Contracting•Network Mgmt•Capitation•P4P•Fee for Service•Rev. Cycle Mgmt
• F & A• HR• Call Center• Admin• Data Security• Legal• IT Infrastructure• Compliance
• Broker Management
• Quotes• Pre-Sales• Sales Admin• New Products
•Transactions•Claims•Eligibility•Enroll / Dis-Enroll•Status•Pre-Certs•RA / ERA•Premiums
• Portals
• Broker
• Sales
• Member
• Prospect
• Dashboards
• Broker
• Member
• Sales
• SFA
• Sales Analytics
• Pricing
• Portals
• Group Services
• Member Services
• Prospects
• Dashboards
• Groups
• Member
• Prospects
•Portals
• Provider
• Group
• Hospital / Institutional
• Out of Network
•Contracting
•Network Mgmt
•U & C Admin
•Medicare and Medicaid Fees admin
•Rev. Cycle, Denials Mgmt
•Claims Systems Mgmt
• System Selection
• Core Systems Migration
• Sun setting
• Data Migration
• Remote management
• Second pass admin.
• Rules Engine mgmt
•Member, Provider, Group data
• Data Quality
• Mining
• Warehousing
• Analytics
• Intelligence
• Knowledge management
• Business value creation
• De-Risking
• Accumulators, alerts Mgmt
• Fraud and Abuse Rules management
• Denial Rules Mgmt
•F & A, HR Systems
• Upgrade, Sun-setting, Management, Modification, Remote management
•Call Center
• Outsourcing, Remote mgmt., Metrics
•IT Infrastructure
• Management, Upgrade, Modification
•Compliance, Data Security
• Audit, Upgrade, Mgmt,
Member Management
Group Management
Network Management
Transactions Management
Knowledge Management
Business Enablers Management
Current State Challenges
Operating Margin = Premiums – (paid claims + operating expenses)
Bus
ines
s / T
echn
olog
y P
roce
ssB
usin
ess
Pro
cess
Bus
ines
s
Act
ivity
PMPM
Business Objectives & Facilitators
• Cost Predictability
• Fraud and Abuse
• Integration
• Data Quality
• Analytics and Intelligence (hBIDS)
• Reporting and Dashboards
• Core Systems Migration and Enhancements
• Compliance
Operating Margin = Premiums – (paid claims + operating expenses)
PMPM
Wellness Continuum
UnderwritingRisk Mitigation
Predictive AnalyticsFraud and Abuse Prevention
Preventive and Proactive Analytics
Outcomes & UtilizationDenials History
Risk Identification and quantification
Reactive Analytics of HistoryDisease & Care Information
Patient InformationProvider Information
Clinical DataClaims DataMember DataProvider data
Dat
a
Info
rmat
ion
Kno
wle
dge
Val
ue
Disease Management
Care Management
Wellness management
Patient Management
Mem
ber V
alue
Cre
atio
n
Mem
ber V
alue
Cre
atio
n
TCS Healthcare Focus
Enhancing Healthcare is one of the top 10 outcomes oriented themes
that TCS will focus on during 2009 - 2010
Enhancing Healthcare is one of the top 10 outcomes oriented themes
that TCS will focus on during 2009 - 2010
• Increase access to care
• Decrease cost of care
• Improve outcomes by
enhancing quality and
optimizing services
• Decrease medical errors
• Make care provision
patient friendly
• Empower patients
• Increase access to care
• Decrease cost of care
• Improve outcomes by
enhancing quality and
optimizing services
• Decrease medical errors
• Make care provision
patient friendly
• Empower patients
• Analytics, Data warehousing and BI
• Dashboards and portals
• E(H/M)R, HMS, CDSS, etc.
• Service orientation and quality processes implementation
• Fraud and abuse management
• Integrated HIS and inter-operability
• Analytics, Data warehousing and BI
• Dashboards and portals
• E(H/M)R, HMS, CDSS, etc.
• Service orientation and quality processes implementation
• Fraud and abuse management
• Integrated HIS and inter-operability
Current State Business Considerations
• Group Admin• Enrollment• Other Group
and Member Processes
• Member Services
• Analytics•Care Mgmt•Disease Mgmt•Wellness Prog.•Underwriting•Risk Mgmt•Accumulators•Denial Mgmt•Fraud and Abuse
•Provider Mgmt•Contracting•Network Mgmt•Capitation•P4P•Fee for Service•Rev. Cycle Mgmt
• F & A• HR• Call Center• Admin• Data Security• Legal• IT Infrastructure• Compliance
• Broker Management
• Quotes• Pre-Sales• Sales Admin• New Products
•Transactions•Claims•Eligibility•Enroll / Dis-Enroll•Status•Pre-Certs•RA / ERA•Premiums
• Portals
• Broker
• Sales
• Member
• Prospect
• Dashboards
• Broker
• Member
• Sales
• SFA
• Sales Analytics
• Pricing
• Portals
• Group Services
• Member Services
• Prospects
• Dashboards
• Groups
• Member
• Prospects
•Portals
• Provider
• Group
• Hospital / Institutional
• Out of Network
•Contracting
•Network Mgmt
•U & C Admin
•Medicare and Medicaid Fees admin
•Rev. Cycle, Denials Mgmt
•Claims Systems Mgmt
• System Selection
• Core Systems Migration
• Sun setting
• Data Migration
• Remote management
• Second pass admin.
• Rules Engine mgmt
•Member, Provider, Group data
• Data Quality
• Mining
• Warehousing
• Analytics
• Intelligence
• Knowledge management
• Business value creation
• De-Risking
• Accumulators, alerts Mgmt
• Fraud and Abuse Rules management
• Denial Rules Mgmt
•F & A, HR Systems
• Upgrade, Sun-setting, Management, Modification, Remote management
•Call Center
• Outsourcing, Remote mgmt., Metrics
•IT Infrastructure
• Management, Upgrade, Modification
•Compliance, Data Security
• Audit, Upgrade, Mgmt,
Member Management
Group Management
Network Management
Transactions Management
Knowledge Management
Business Enablers Management
Bus
ines
s / T
echn
olog
y P
roce
ssB
usin
ess
Pro
cess
Bus
ines
s
Act
ivity
Innovative Solutions
• Robodoc TeleMed Solution
• TeleMed Kiosks
• Remote Patient Monitoring and Alert Solutions
• Outcome based Outpatient Reimbursement
Core Solutions
• System Integration & Application Support
• Application Development and maintenance
• Assurance and QA services
• Interoperability and Clinical infrastructure Solutions
• Clinical Intelligence
• Web based Solutions• Portals• Mail-order prescription fulfillment• Specialty Pharma fulfillment
• Regulatory Compliance Solutions
• RFID Systems, Bar Coding Solutions
• HMS, EMR, CPOE
• Fraud and Abuse Alert Solutions
• Mobility EMR Solutions
• Quality Monitoring Dashboards
• Revenue Assurance & Management
• Triage and Care Plan Solutions
Adaptive Solutions
Payers & PBM
• Cigna• Kaiser
Permanente• BCBS• Humana
Providers
• NHS (UK)• Mt. Sinai Hospital• Multiple Hospitals
in India
Pharmacies & PBM
• Walgreens• CVS
Caremark• Pharmerica
Pharmaceuticals
• Eli Lilly• Glaxo• Abbott Labs• Merck• Pfizer• J & J
Sample Customers
Government
• Tricare Program (Military)
• PA Dept of Health
IT / Product Vendors
• GE Healthcare, IDX
• Misys Healthcare
• QuadraMed
Experience & Sample Customers
TCS Confidential
THANK YOU!!Andrew Chu
Director of Business Development
Office: 732-590-2784
Cell: 862-324-1134
Mailto: [email protected]
Ramesh Raghavan
Global Head - Healthcare Practice
Office: +91 11 6650 6555 ext 276
Cell: +91 9717 702 430
Mailto: [email protected]
AppendixAbout TATA and TCS
10
Tata Heritage - Beyond Business
Group
Passionate commitment to developing the communities in which we operate: 66% Equity of Tata Sons in Public Trusts
Activities› Endowments for National Institutions:• Indian Institute of Science•Tata Institute of Social Sciences•Tata Memorial Hospital•Tata Institute of Fundamental Research•National Center for Performing Arts
› Development assistance
› Foreign scholarships - science / engineering
› Annual Spend ~$35MM Social Welfare Expenditure budgeted before P&L
› Commitment to Community in company Articles of Association
› Active Volunteering Program with Over 15,000 volunteers
“In a free enterprise, the community is not just
another stakeholder in the business, but is in fact the
very purpose of its existence”
- Jamsetji Tata, Founder
Unmatched Breadth and Depth of Industry Knowledge
Banking/Financial Services
Insurance Energy & Utilities
Government Life Sciences & Healthcare
Manufacturing Retail & Consumer
Goods
Telecom, Media
& Information Services
High Technology
Travel, Transportation
& Hospitality
TCS Industry Expertise
Tata Businesses
India’s Largest Conglomerate
98 Operating Companies in 7 Business Sectors
Some Recent International M&A Activity:
Combined company now 5th
largest steel producer in
the world
One of Asia’s largest hotel companies
expands into U.S.
Taj Hotels Boston Ritz
Carlton [ $170MM ]
Largest provider of submarine
cable bandwidth
2nd largest global branded tea
operation
Tata TeaTetley / Good
Earth Tea[ ~$1B ]
Company significantly
broadens product line and global
footprint
Tata MotorsJaguar/
Land Rover [ ~$2.3B ]
VSNLTyco Global Networks/Teleglobe[ $369MM ]
Tata Steel Corus Steel
[ $13B ]
TCS Corporate Facts
›Established in 1968
›Part of the Tata Group
›Over 111,000 Employees in 47 Countries
›FY 2007-08 Revenues of US $5.7 billion
›Public Company - Market Cap of US $20 billion
›Lowest attrition rate (12.6%LTM)
›Established in 1968
›Part of the Tata Group
›Over 111,000 Employees in 47 Countries
›FY 2007-08 Revenues of US $5.7 billion
›Public Company - Market Cap of US $20 billion
›Lowest attrition rate (12.6%LTM)
TCS Revenues in US$ Millions
$0
$1,000
$2,000
$3,000
$4,000
$5,000
$6,000
’98 ’99 ’00 ’01 ’02 ’03 ’04 ’05 ’06 ’07 '08
* All Figures as of March 31, 2008
Full Services IT Player
Ultimatix
IPMS
iQMS
Mig
htyKnowmax
iCALMS
Retail & Consumer
Goods
Life Sciences & Healthcare
Banking & Financial Services
Insu
ranc
eGo
vern
men
t
Travel & Hospitality
Manufacturing & Hi-tech
Telecommunication
Technology CoEs
Innovation Network
Domain CoEs
Alliances
Industry Aligned Service Areas
16
Year 2007 - 08
Revenue – US$ 325 mill Number of associates – 4500 Domain people – 850+ (~20%)
TCS Life Sciences & Healthcare Domain
0
500
1000
1500
2000
2500
3000
3500
4000
4500
No
. o
f A
ss
oc
iate
s
'02-'03 '03-'04 '04-'05 '05-'06 '06-'07 '07-'08
$0
$50
$100
$150
$200
$250
$300
$350
Re
ve
nu
e (
Mil
lio
n U
SD
)
'02-'03 '03-'04 '04-'05 '05-'06 '06-'07 '07-'08
ISU structure
Increase wallet share Focus: NA & Europe
KPO/BPO & Engineering & Industrial
TCS Life Sciences & Healthcare Overview
Healthcare
Life Sciences
Pharma
Medical Devices
North America
Europe and UK
Asia Pacific
India
Number of Clients: 100+
Number of Engagements: 648
Project Experience: 2500+ PYR
4500+ Associates
Sub Practices Focus Geographies Highlights
Lead Critical Industry Trends - EHR, Clinical Trials, Bioinformatics, Telemedicine Commitment to Long Term Investments - TATA Bio-Suite, Webhealthcentre Tata
HMS, Tata CTMS, Thought Leadership – Emergence of Healthcare Globalization, Interdependence of
Healthcare Sub-Domains, Global Best of Breed to Lower HIT/EHR Cost Thresholds Domain based Delivery Engagements - Knowledge sharing, conceptualization of
business model frameworks, domain perspective review and audits
Focus Areas
Healthcare
Business Process
Definition
Business Process
Definition
Business Process
Outsourcing
Business Process
Outsourcing
Helpdesk Services
Helpdesk Services
Business Process Re-engineering
Business Process Re-engineering
Business Intelligenc
e
Business Intelligenc
e
Architecture
Architecture
Application Rationalizati
on
Application Rationalizati
on
Product & IT
Roadmap
Product & IT
RoadmapEvaluationEvaluation
Hospital Manageme
nt Systems
Hospital Manageme
nt Systems
Business Intelligenc
e & Analytics
Business Intelligenc
e & Analytics
Clinical Decision Support Systems
Clinical Decision Support Systems
Clinics Mgmt
Clinics Mgmt
HL7 & DICOM Engine
HL7 & DICOM Engine
Workflow Optimizatio
n
Workflow Optimizatio
n
Systems Integratio
n
Systems Integratio
n
Reengineering &
Migration
Reengineering &
Migration
Maintenance &
Development
Maintenance &
Development
Testing Services
Testing Services
Infrastructure Services
Infrastructure Services
TCS Healthcare Industry Solutions Unit Offerings
Healthcare Provider
- 19
-
Healthcare Payer
- 20
-
TCS Broad Portfolio of Offerings
IT ServicesOutsourcing SolutionsEnterprise SolutionsTechnology Solutions
Engineering & Industrial ServicesEnterprise Asset ManagementIndustrial Embedded SystemsPlan Automation ServicesProduct Engineering
IT Infrastructure SolutionsInfrastructure OutsourcingNetwork Consulting & IntegrationHardware Support & InstallationInfrastructure Management
ConsultingEnterprise Transformation & Change ManagementBusiness Process ManagementSystems & Application ArchitectureIT Process ManagementOutsourcing Process Management
Business Process OutsourcingFinance & Accounting OutsourcingHR OutsourcingCustomer Care OutsourcingSupply Management SolutionsVertical Solutions
Product Based SolutionsTCS B⍺NCSVertical Industry SolutionsProductivity Tool Solutions
Delivery Centers: Global, Domestic & Near-Shore
Near-shore Centers
Domestic DeliveryCenters
Global DeliveryCenters
› Toronto› Phoenix› Guildford› Peterboroug
h
› Cincinnati› Uruguay› Mexico› Brazil› Hungary› Morocco
› India › China
(emerging)
Breadth of Skills HighLow
Scale HighLow
Low
High
Cu
sto
mer
Pro
xim
ity
High
Low
Cu
sto
mer
Covera
ge
Global Delivery Centers
› Very high scale
› Serves large customers
› High depth & breadth of skills
› Matured processes
Domestic Delivery Centers
› Medium scale
› Serves local customers
› Select capabilities
› Addresses language and cultural challenges
Near-Shore Delivery Centers
› Smaller scale
› Customer geography & time zone
› Helps to build customer comfort
The TCS Difference
Broad Portfolio of OfferingsProviding the right set of capabilities for the right opportunities at the right time
Global Network Delivery ModelTM Our unique business model for consistent delivery of high quality, cost effective services anywhere, any time
Solution AcceleratorsProducts, tools and methodologies to help bring client solutions to market more quickly and with higher quality
TCS Innovation Labs and Co-Innovation Network Our innovation engine to help clients achieve and maintain competitive advantage
THANK YOU!!
Andrew Chu
Director of Business Development
Office: 732-590-2784
Cell: 862-324-1134
Mailto: [email protected]
Ramesh Raghavan
Global Head - Healthcare Practice
Office: +91 11 6650 6555 ext 276
Cell: +91 9717 702 430
Mailto: [email protected]