Healthcare Case Study
A Medicare prequalification insurance provider partnered with Outsource Consultants to scale peak-season support and overhaul a broken warm-transfer system.
The results: 75% cost reduction and a $250 million revenue leap in just one year.
Results
- 57%
- Cost Reduction
- $250M
- Revenue Growth
- 88%
- Transfer Rate
- 1.7x
- Handoff Improvement
The Challenge
A fast-growing Medicare prequalification insurance provider was struggling to keep up with extreme seasonal enrollment spikes. Their rigid in-house support model was too costly to scale, and inconsistent warm-transfer handoffs to licensed agents were causing revenue leakage. Despite strong demand, the client lacked the operational flexibility and transfer efficiency needed to convert interested callers into enrolled members. With open enrollment approaching, they needed a compliant, scalable, and cost-effective CX model quickly.
The Approach
Outsource Consultants guided the client through a shift from a fixed in-house structure to a flexible seasonal outsourcing strategy. The focus was on rebuilding the warm-transfer process by implementing a script-driven model that ensured Medicare compliance and consistent, accurate handoffs. This allowed the operation to deliver a reliable transfer experience during high-demand periods.
The new model also expanded the client’s capacity from 25 agents to more than 300 during open enrollment while aligning partner capabilities with revenue-critical KPIs. With these adjustments in place, the client saw rapid performance improvements. Within 90 days, transfer efficiency soared past their goal, proving the model both scalable and highly effective.
The Outcome
The restructured CX model delivered outstanding gains in both cost and revenue. The provider surpassed its target transfer rate of 51% and reached an 88% warm-transfer rate, which was 1.7 times higher than before. Moving to an outsourced model reduced first-year costs by 57% and created $1.3 million in immediate savings.
These efficiency improvements also drove significant revenue impact. Annual revenue increased from $764 million to $1 billion in the first year, a jump of $250 million. Over the full engagement, the client achieved $5.2 million in total long-term savings while accelerating growth rather than limiting it.
Results:
- 57% first-year cost reduction
- 1.7× higher handoff rate
- 88% warm-transfer rate
- $1.3M immediate savings
- $5.2M total long-term savings
- 30% revenue growth in year one
- $250M increase in annual revenue
FAQs
- How do I know these results are achievable for my organization?
We’ve worked with startups, mid-market teams, and global brands. No matter your size or complexity, we model expected outcomes based on your actual volumes, workflows, and goals. Our benchmarks come from thousands of live programs, not just assumptions.
- What does the engagement process actually look like?
We handle the full journey: discovery, partner match, launch, and oversight. You get expert guidance, vetted partners and a clear path from kickoff to results.
- How does OC ensure compliance in regulated industries?
We only match clients with BPOs that have proven experience in highly regulated environments. That includes handling HIPAA, PCI, and CMS requirements with full audit trails, process controls, and dedicated QA programs built for compliance.
- How long until we see results?
Most clients see impact within 60–90 days. Ramp and stabilization depend on scope, but our launch playbook keeps timelines on track.
- What internal lift is required?
Minimal. You share your goals, systems, and content then we handle the rest. Need help with QA, scripts, or reporting? We’ve got you covered.
- How is performance managed and improved?
We act as your performance translator and expert, aligning expectations, supporting the cadence you need, and keeping both sides clear, informed, and working smoothly together.
Through structured, data-driven touchpoints, we guide and facilitate interactions with the BPO, stepping in when results don’t meet expectations. Our goal is to strengthen a long-term, strategic partnership that supports your needs today and aligns with where your company is headed.
