Helping organizations engage people and uncover insight from data to shape the products, services and experiences they offer
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Changing public healthcare delivery and payment models are transforming the industry. Let us help you deliver a swift response.

Healthcare reform promises to funnel new customers to government and public health programs. Yet budget restraints put pressure on healthcare organizations’ ability to expand services and manage their influx of members. At the same time, constituents demand accountability for their tax dollars, alongside calls for improved services and efficiencies.

Our technology and business processes allow you to address immediate issues presented by health reform and related regulatory actions. We help you to quickly and cost-effectively adapt to whatever unexpected requirements the future may bring.


Regulatory Compliance

Cognizant helps healthcare organizations evaluate the impact of regulatory requirements and implement supporting solutions to help ensure compliance.

  • ICD-10
  • Health Insurance Exchanges
  • Dual eligible
  • Medicare Advantage
  • MITA 3.0

Integrated Health Management (Health 2.0)

Cognizant helps healthcare organizations evaluate, prepare and implement the transformational programs necessary to provide coordinated, comprehensive care for patients and consumers.

  • ACO
  • mHealth
  • Health Insurance Exchanges
  • Health Information Exchange
  • Care coordination/management

Health Intelligence and Analytics

The ability to access and leverage data is changing the way business decisions are made, with rich insights enabling evidence-based decision-making and proactive planning. Cognizant helps healthcare organizations integrate multiple data sources and technologies to increase productivity and drive collaboration.

  • Analytics strategy
  • ACO
  • Process innovations

Investigative Services

Enabling organizations to identify and resolve intentional and unintentional errors or verify the absence of both is critical. With significant dollars being lost to fraud and abuse each year, investigation and recovery efforts are critical to an organization’s overall financial health. Our solutions span these areas:

  • Audits
  • Over/under payment recovery
  • Fraud and abuse

Operational Improvement

By introducing IT-enabled processes, organizations can reduce costs while improving process efficiency and effectiveness. At the same time, these processes can drastically improve overall patient and/or member satisfaction. Cognizant’s expertise includes:

  • Best-in-class series (Claims, Enrollment, Medical Management)
  • Requirements
  • Product evaluation and selection
  • Operational readiness (BPS)


New consumer-focused operating models in healthcare require a shift in thinking, forcing many companies to move from a B2B to a B2C focus. Cognizant helps healthcare organizations understand the requirements for health benefit exchanges and manage the patient and member experience with solutions that drive engagement—and help build effective strategies for member identification and retention.

  • Customer engagement
  • Customer experience
  • Customer retention

Implementation Services

We offer complete project and IT implementation and support services, including:

  • Legacy systems modernization
  • Administrative, claims management, clinical and electronic health record implementations
  • Custom development and maintenance
  • Systems integration and program management
  • ERP and CRM systems
  • Data warehouses
  • E-health, self-service applications and portal development

Medicaid Management Information Systems

With extensive experience on all MITA business areas and a solid foundation in Medicaid information architecture, Cognizant provides a wide range of services to help MMIS vendors execute and manage large transformative MMIS implementation or modernization programs. We also provide project management and staffing services to help states implement MMIS.


Government Solutions for Today’s Healthcare Challenges

Health plans that serve the government programs healthcare market are presented with both challenges and opportunities. Having the right strategic partner that can support end-to-end capabilities across your business can make the difference in achieving success now and into the future.

Realize the Full Potential of Health Insurance Exchange Participation

The Health Insurance Exchange (HIX) market represents a dynamic shift in the healthcare industry’s foundations and HIX participants like your organization are pioneers in testing its new structures. Cognizant is ready to be your partner, guiding your organization through HIX open enrollment and ongoing operations.

Meet Balancing Incentive Program (BIP) Requirements

Taking advantage of the Balancing Incentive Program (BIP) funding offered under the Affordable Care Act can help states better manage their healthcare costs while increasing access to non‑institutional long‑term care services and support (LTSS). We offer a comprehensive BIP solution of prebuilt frameworks, templates, best practices and start‑up kits to help state Medicaid agencies meet BIP requirements and achieve BIP benefits.

Streamline Your ICD-10 Transition

Whether you require a strategy for end-to-end transition or focus around a specific aspect of migrating to ICD-10, Cognizant offers the full range of industry consulting expertise, tools and implementation experience to ensure a smooth transition.

Government and Public Health Plans | Cognizant Technology Solutions