Excellus BCBS Turns to MEGA Solutions to Consolidate IT Systems |
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Written by U.S. Insurance News
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Friday, 04 January 2008 |
When several upstate New York Blue Cross Blue Shield organizations merged, creating New York’s largest nonprofit health plan, they knew that they were not creating just a new name, Excellus BCBS.
When several upstate New York Blue Cross Blue Shield organizations merged, creating New York’s largest nonprofit health plan, they knew that they were not creating just a new name, Excellus BCBS. All of the disparate IT systems and business processes had to be consolidated into the new entity. Because many of the systems and processes were so different, this consolidation could have turned out to be a daunting task. Additionally, elimination of systems redundancy was critical.
After Excellus BCBS scrutinized several providers against certain criteria, the company discovered that the MEGA Modeling Suite had the most comprehensive offering. That is why the nonprofit health plan turned to industry-leader, MEGA International.
Excellus BCBS was able to identify all company functions and processes with the help of the modeling suite. It has worked to reduce duplicate processes that are a normal result of a merger. With multiple platforms and environments, it was extremely challenging to create smoothly running, cohesive business processes, without a clear understanding of what processes and systems were serving each organization.
Many of these legacy systems, some in place for 30+ years, didn’t have adequate documentation, so there were parts of the systems that were completely unknown.
The goal of the health plan was to create a unified system to handle claims processing, provider contracting, member registration, and more. Practices also needed to be standardized so customers and others outside the organization would feel like they were dealing with a single company, rather than multiple entities in a loose federation.
Excellus BCBS also recognized that incorporating a services-oriented architecture (SOA) approach would be a key factor to their success. SOA provides the ability to devise flexible architectures that rely on smaller parts (services), rather than larger holistic solutions. Being able to implement the architecture in parts gives them more choices (buy vs. build) and allows for variation in particular components to adapt to shifting market demand for products. From the onset it was apparent that going forward with big systems implementations would drive both risk and financial resource to unacceptable levels.
“With the MEGA Modeling Suite, we have gained a clear understanding of our processes and we have put the information in one place so that we can maintain consistency, starting at the architectural or planning level,” commented Eric Stephens, enterprise architect, Enterprise Architecture and Integration Team at Excellus BCBS. “Previously, we relied on individual people for their knowledge, as well as slides and Visio diagrams, but it was not nearly enough.”
Excellus BCBS is making more efficient use of its resources (people, money, time, equipment) and is improving access to company information with the help of the new modeling system. The MEGA Modeling system is increasing business agility, enabling the maintenance of the health organization’s competitive edge while reducing time to market for new products. Excellus is also able to respond to market changes rapidly, allowing identification of the impact of organizational change before making actual changes through modeling. This process avoids problems, and saves time and money.
The ability to remove redundant hardware and software has had the affect of creating additional savings. Another result of the implementation is the repurposing staff for value-added activities.
MEGA International provides enterprise architecture (EA), business process analysis (BPA), and governance, risk, and compliance (GRC) solutions that are used by corporations and government agencies. The tools help them understand assets, control operations, and govern risks.
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