Helping hand

Beginning life in the United Kingdom back in 1998, DC Risk Solutions was formed to provide an insurance solution for high severity, low frequency medical claims. Now, more than two decades on, the firm has released its latest product, Integrated Payor Solutions as a salesforce-native medical claims adjudication and payment platform. It is this innovation that has seen DC Risk Solutions earn the title of Most Innovative Cloud-Based Technology Provider 2020 – Healthcare. Join us as we find out more.

Over the course of twenty two years, DC Risk Solutions has gained a reputation for being a company that has been able to take decisive action quickly in response to threats and opportunities. The philosophy of “find a need and work to offer a solution” has underpinned the work since its beginning, and it is unafraid of working with colleagues and competitors alike to support the market as a whole. In its latest venture of supporting the healthcare market, DC Risk Solutions has developed Integrated Payor Solutions. Currently, payor organizations need to access multiple systems and input the same information multiple times to be able to manage, pay, and provide reporting on medical claims to be compliant with the rules and regulations. Instead, DC Risk Solutions built a singlepoint of service system where all of the information resides, where administrators and any third-party service providers can access the information and work in a secure environment.

Integrated Payor Solutions was built to give a first-in-class Medical Claims Administrator Solution for small-to-medium firms built on Salesforce with all the security, integration capabilities, and scalability being salesforce-native brings. This is a SaaS model that is priced on a per-employee per-month basis, which tracks directly with their clients’ revenue. The current market offerings are a combination of homegrown and purchased technology for specific tasks that generally do not work well together. In many cases, clients have to bundle different programs together and build work arounds where they are not readily compatible, and there was previously no one platform that did everything.

Enter, Integrated Payor Solutions. DC Risk Solutions started by approaching traditional third-party administrators as the firm saw this opportunity to reduce costs and improve patient outcomes. The firm partnered early on with ancillary service providers such as Pharmacy Benefits Manager, and medical review and wellness companies, which revealed that technology was often the roadblock to total fluidity and success. Very little is possible without real time data delivered at the right place and time where it can be used effectively, so these partners wanted DC Risk Solutions to help them get the data they needed. The firm set about creating its system, which has subsequently been marketed to the entire claims paying universe. With its single modular system, Integrated Payor Solutions can act as a bridge or a complete solution.

The internal culture of DC Risk Solutions is one that has been cultivated from the ground up by founder and leader, Shawn Evans. Prior to working at DC Risk Solutions, Mr Evans worked at Lloyds, as part of a small team who specialized in the healthcare sector and needed to work together with a common goal whilst competing daily.

As a collective group, Mr Evans and his team had to look at all of the clients as an important part of the market, so everyone supported one another. This culture of positivity and collaboration has fed into the atmosphere that Mr Evans has cultivated at DC Risk Solutions. The firm is about delivering better, faster, and cheaper healthcare solutions to the employees and members that its clients serve, but the staff are at the heart of that mission.

Staff are critical to any mission, but at DC Risk Solutions, they are each handpicked by Mr Evans himself, who knows all too well what skills and elements make a perfect team. Each staff member adds to the organization with different ideas and perspectives that will make a difference. DC Risk Solutions has a very flat management structure where Mr Evans expects team members to look at their work, and the work of its clients, and figure out how it can be made more efficient. The entire Integrated Payor Solutions platform was a collaboration of individuals with programming, claims paying, healthcare, and operations backgrounds. Mr Evans assembled the team and empowered them to make a difference to the healthcare industry.

Recruitment has proven to be a challenge for DC Risk Solutions, as it is a Salesforce shop where the competition for talent is extreme and the healthcare sector cannot afford the wages presented by many competitors. Instead, DC Risk Solutions aims to hire students and new graduates for the technical positions as they are drawn by the appeal of helping others by making the healthcare sector better for everyone, and do not simply look at the salary. The firm also commits to the students and graduates that they will get a lot of interested projects and hands-on experience which they can take with them when they leave. In addition, the firm is always having to look out for talent wherever it exists in the world. As a cloud-based platform, much of the work can be done from anywhere in the world, including the United States, Turkey, and Lebanon.

Overall, the healthcare industry in the United States has been in a state of constant change since the mid-1990s, when Mr Evans initially started his career in the industry. Healthcare in the United States represents 17% of the nation’s GDP, but politics still remains the greatest challenge. Over the years, there have been many reforms and regulations which are then integrated into the business model. However, when elections see the power change hands, everything is rolled back. The Accountable Care Act is a prime example of DC Risk Solutions building systems to comply, only to then have them made redundant a few years later at great cost to everyone involved.

Yet, DC Risk Solutions launched the Integrated Payor Solutions under shelter in place restrictions. It has to change the rollout strategy, as the conferences have had to be virtual, but the success
has been unparalleled. With more and more people choosing to work from home, cloud solutions have been supercharged as clients and prospects need flexible, secure systems that can be deployed anywhere. As this may become the new normal, DC Risk Solutions anticipates the ability to work remotely will be necessary for the foreseeable future. At the same time, the firm is modifying the Payor Solutions solution for insurance agencies and underwriters, which it plans to launch in 2021 following the beta testing stage.

Few can predict which way the healthcare industry will be made to turn next, especially in an election year in the United States. That is why it is absolutely critical that DC Risk Solutions are about flexibility and change, as no-one knows what they future brings for the healthcare industry. Ultimately, the firm is flexible and adaptable enough to allow its clients to react quickly with minimal disruption and additional costs. With excellence at the helm in the form of Mr Evans, DC Risk Solutions is one of the finest innovators in an American industry that desperately needs it.