Humana
Healthcare Insurer Boosts Operational Efficiency and Customer Satisfaction
Humana is one of the United States’ largest publicly traded health benefits companies with approximately 6.4 million medical members across 18 states and Puerto Rico. The company contracts with approximately 330,000 physicians, 2,500 hospitals and 39,000 pharmacies.
The insurer’s success is due, in part, to its ability to transform obstacles into opportunities. One such opportunity arose when Humana decided to launch a companywide e-business transformation to answer challenges facing the health insurance industry – including administrative inefficiencies, increasing costs, lack of standards, reduced payments and consumer concerns over coverage, costs and control. If successful, Humana stood to not only optimize its operations, but also gain a compelling competitive edge.
As part of this strategy, Humana designed an interactive, Web-based health plan, Emphesys. Through it, Humana would connect vastly divergent groups of users – plan participants, employers, doctors and insurance brokers – into a high-performance online community that sets new standards for informed interaction and collaboration. Consumers would enjoy nearly instantaneous service and direct control over their individualized benefit plans. Humana would decrease its time to market and ensure rapid, reliable public access to its new products and benefits. To make it all happen, however, the insurer needed a custom-designed e-business platform, which would allow intensive, integrated data processing in real time.
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