Suraya Yahaya, Chief Operations Officer and Scott Martin, PresidentWith the state of healthcare is constantly evolving, payers are faced with the challenge of finding ways to reduce costs and improve healthcare outcomes for their members. In this environment, Business Process Outsourcing (BPO) providers, like Catalyst Solutions, are becoming increasingly important. BPO providers allow payers to streamline their operations and focus on their core competencies, while outsourcing non-core functions to partners with greater expertise and greater scales of economy.
Healthcare Business Review had the opportunity to interview Scott Martin, president of Catalyst Solutions, and Suraya Yahaya, Chief Operations Officer at Catalyst Solutions, about the importance of BPO in the payer market and how Catalyst is driving outcomes as a provider of Outsourcing Services.
Healthcare Business Review (HBR): Tell us a bit about why Business Process Outsourcing is so important in today’s market.
Scott Martin: Healthcare plans, like organizations in every other vertical, are working to drive down costs and activities – but, more importantly, they are finding that outsourcing also allows them to focus on what they do best, which is: improving the healthcare outcomes of their membership.
Suraya Yahaya: And this is where Catalyst Solutions can really help.
With almost 25 years of experience in the healthcare industry, Catalyst has broad and deep knowledge relating to payer technology and payer operations. We have commoditized the processes of what plans refer to as the back-office and the middle office.
This specialization allows us to perform these activities more cost-effectively and, with our scales of economy, allows us to scale to best meet their business needs.
HBR: Tell us more about these services.
Suraya Yahaya: We provide a wide range of outsourcing services to our clients: claims processing, configuration, call center, enrollment, and grievance and appeals. We also provide clinical services for the healthcare plan, like Utilization Management, Care Management, Authorization and Referrals.
Scott Martin: We also provide consulting services to payers, helping them with Operations and Technology Optimization. We are committed to providing comprehensive and flexible solutions that meet the unique needs of our customers.
Suraya Yahaya: And that’s really important. Our customers find that the initial cost savings with outsourcing are significant, but the benefits Catalyst provides go beyond that. We engage with our clients at a strategic level. We commit to long-term collaboration. We invest in continual improvement to our people, processes and technology – always looking for ways to innovations and produce business results that drive tangible results.
HBR: Obviously, people are an important factor in outsourcing. How have the changes in the labor market affected Catalyst?
HBR: Often times innovation is synonymous with technology. Does Catalyst offer any technologies with their BPO?
Scott Martin: We do. With almost twenty-five years in the industry, Catalyst has had the pleasure of working with some of the most innovative technology vendors in the industry. We can provide our clients with everything from core platforms, clinical solutions, telephony, customer relationship managers (CRM) and a host of other solutions.
With almost 25 years of experience in the healthcare industry, Catalyst has broad and deep knowledge relating to payer technology and payer operations
HBR: Obviously, people are an important factor in outsourcing. How have the changes in the labor market affected Catalyst?
Suraya Yahaya: Catalyst hasn’t experienced much of an impact. Our Recruiting capability is very mature and sophisticated. We are able to bring in and retain the best people.
HBR: What does that mean? Best people?
Scott Martin: We are very selective in who we hire. We only recruit people who have a deep understanding of the healthcare landscape and are committed to delivering high-quality service to our clients. Our people, each and every one of them, are passionate about making positive and measurable change on behalf our clients and the communities in which we live.
HBR: What would your customers say about your services?
Scott Martin: I would say: ask them. It’s what we encourage every payer to do before we start a partnership.
And the reason I say that is that Catalyst takes great pride in knowing our clients are extremely satisfied with the services we provide. They appreciate the level of expertise and commitment we bring to the table. They appreciate the positive impact we have on their operations. You see, our services don’t end with outsourcing. We become our customers’ trusted advisor and collaborate with them in achieving their desired future.
HBR: You’ve mentioned trusted advisor and partnership. What does that mean to you?
Suraya Yahaya: At Catalyst Solutions, we understand that every client is unique. We take a customized approach to working with each one. We maintain a tight integration with our clients; regularly communicating with them, keeping them informed of our progress, and working closely with them to identify areas for improvement.
HBR: It’s been great speaking to you both, thank you for your time today.
Scott Martin/Suraya Yahaya: Thank you.
Catalyst Solutions is a BPO provider that is exclusively focused on serving the payer industry. Catalyst provides a wide range of services, including claims processing, call center support, data analytics, and IT consulting. Catalyst’s mission is to extend our technology services and skilled labor force to provide payers with expertise and scalability so they can focus on what really matters: changing healthcare – making it affordable for their members and making the health of those members better.
Reimagining Healthcare BPO for an AI-Driven Era
Healthcare business process outsourcing stands at an inflection point. For decades, its economic logic centered on labor arbitrage, scale and incremental automation. Health plans pursued lower administrative costs by moving work offshore and standardizing processes into repeatable tasks. That model delivered savings, yet its ability to create further value has narrowed. Competition among large providers has intensified, pricing pressure has increased, and geopolitical dynamics have introduced new uncertainty into globally distributed delivery structures. Cost alone is no longer a sufficient differentiator.
Health plan executives now face a more complex mandate. Administrative budgets remain under scrutiny, yet regulatory change, fragmented legacy systems and expectations for agility continue to rise. Many payer environments still rely on monolithic core platforms, multiple enrollment systems and heavily customized configurations that make even modest process adjustments slow and expensive. When policy shifts require rapid redeterminations or benefit changes, technology constraints become strategic barriers. In this context, outsourcing must be judged not simply on headcount economics but on whether it enables business reinvention.
A more durable model begins with deep healthcare domain knowledge. Processing claims, managing subrogation or interpreting regulatory updates requires more than task execution; it requires contextual judgment built over years of industry immersion. When expertise is embedded into the delivery model rather than stripped out in the name of efficiency, the total cost of ownership changes. Reduced rework, lower attrition impact and improved communication translate into measurable financial benefit even if unit pricing appears higher.
The second dimension is credibility in artificial intelligence. Many providers promote AI initiatives, yet in practice, these often resemble limited automation layered onto traditional staffing constructs. True transformation demands that industry knowledge shape the design, training and oversight of AI-driven processes. Technology components such as large language models are becoming commoditized. Differentiation increasingly depends on how well they are tuned to the nuances of healthcare reimbursement, compliance risk and payer operations.
A third shift concerns architecture. Health plans rarely have the appetite or capital for wholesale system replacement. Value emerges when an outsourcing partner can work across existing platforms, orchestrating processes above the core transaction engines. A modular framework that integrates with diverse systems, aligns workflows with business objectives, and enables rapid configuration changes offers agility without forcing disruptive rip-and-replace projects. This process-first orientation allows the business to define how it wants to operate, while technology serves as an enabler rather than a constraint.
Catalyst Solutions aligns closely with these emerging expectations. Drawing on three decades of payer experience and operating across 48 states, it anchors its model in onshore expertise and measurable outcomes rather than headcount scale. It embeds domain specialists into both service delivery and AI development, creating what it describes as AI employees trained and supervised by seasoned professionals. Its Catalyze framework functions as a process orchestrator that integrates with existing core systems, enabling plans to redesign workflows without abandoning prior investments. Pricing is structured around guaranteed results, reflecting confidence derived from deploying its AI capabilities within its own operations before extending them to clients. For health plans that require both disciplined cost control and genuine business reinvention, Catalyst Solutions represents a compelling choice grounded in healthcare-specific knowledge and accountable performance.
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