Mastercard Healthcare Solutions will develop and provide the tools needed to create efficiencies that enable healthcare organizations to focus on what matters most, helping people enjoy healthy lives.
Mastercard today unveiled Mastercard Healthcare Solutions, a new suite of products dedicated to helping healthcare partners detect fraud, waste, and abuse, capture more revenue, and protect patient health data.
Bringing its scale and advanced technology to healthcare, Mastercard is transforming its business by moving beyond cards and reimagining how its technology and capabilities can benefit the healthcare ecosystem. These solutions build upon Mastercard’s established role in healthcare – helping businesses provide their employees with convenient, reliable access to healthcare funds through Mastercard-branded Flexible Spending Account (FSA), Health Savings Account (HSA), and Health Reimbursement Arrangement (HRA) cards.
In a world that is increasingly digital-first, patients have come to expect seamless, real-time digital experiences in nearly every aspect of their lives. While healthcare organizations have the technology to preserve and enrich lives, the rapid technological change is putting pressure on them to keep pace and quickly adapt. Mastercard Healthcare Solutions will allow healthcare payers and providers to have the right tools to address rising digital threats and operate more efficiently.
“The healthcare industry is experiencing a significant transformation and Mastercard’s technology-driven solutions will help stakeholders including payers, providers and in the long run patients,” said Raja Rajamannar, chief marketing and communications officer and president, healthcare, Mastercard. “Our solutions range from helping payers detect and reduce fraud, waste, and abuse to offering tools to providers to help improve patient receivables.”
Mastercard Healthcare Solutions brings its capabilities to complement a partner’s existing system to address major pain points such as payment assurance, payment integrity, and cybersecurity. Unlike other new entrants to the industry, Mastercard Healthcare Solutions will enhance partners’ businesses, not compete with them.
Patient Payment Assurance: Predictive analytics to enable more effective billing strategies tailored to patient needs
- Using the Mastercard Test and Learn® platform, health systems can optimize billing with predictive analytics that considers a patient’s unique circumstance. Providers will be able to:
- Segment patients based on payment burden, individual payment behaviours, and other factors
- Analyze relevant business drivers and past behaviors to determine the optimal billing approach
- Develop new billing strategies customized to the patient’s unique profile
- Measure the impact of differentiated billing strategies to continuously refine the approach
Fraud, Waste, and Abuse: AI and machine learning to detect suspicious claims activity
- Mastercard Healthcare Solutions will use artificial intelligence models to identify healthcare claims fraud and other pain points in the health system. Partners will be able to take the uncertainty out of claims management with advanced techniques to:
- Assess new providers to reduce onboarding risk
- Continuously monitor provider behaviour and risk levels
- Address omnichannel fraud across vectors, channels, transactions
- Manage daily transaction fraud risk in real time
Data Security: Biometrics and behavioural analytics to protect health information
- With healthcare data breaches rising steadily, securing health and payments data is a top priority for the healthcare industry. Leveraging behavioural analytics, biometrics, and risk assessments, Mastercard Healthcare Solutions can help:
- Authenticate mobile access to HSA accounts, call centres, and patient portals
- Mitigate automated cyberattacks and data exposure on websites and mobile apps
- Detect cybersecurity threats in real-time to lower operational and investigative costs
- Identify security and ID management gaps in IT systems and processes
- Reliably authenticate patients during new account enrollment
