Earlier this week I was noodling over a topic for my first blog post. My intention for this blog is to bring a practitioner's perspective on ECM to the community; to share and collaborate on best practices and approaches that address today's business problems. Reviewing my past 14 years of experience with web technologies, I wondered what topic would serve as a good "conversation starter". During this time, I received a call from a friend who was seeking insights on how content management applies to specific industries. She approached me because she vaguely remembered that I had worked in the Health Insurance industry in the recent past. She wanted me to tell her about the specific business needs of this industry. She was in for quite a surprise as she found out that I had spent the better part of a decade managing content within the Health Insurance industry and I discovered a great topic for my first blog post!
I offer some insights from Health Insurance and invite my fellow practitioners to share their insights from other industries. What does content management mean to these industries? What can solution providers be aware of when offering solutions to these industries?
The United States health care system relies heavily on private health insurance, which is the primary source of coverage for approximately 58% Americans. In the late 19th century, "accident insurance" began to be available, which operated much like modern disability insurance. In the late 20th century, traditional disability insurance evolved into modern health insurance programs.
The first thing a solution provider must be aware of about the Health Insurance industry is that it tends to be transaction intensive. They are the ones who manage and administer our health plans and process our claims when we visit our health care providers. It helps to keep in mind that they are in the business of delivering health insurance and not technology. You may find the mindset conservative in comparison to the IT industry, however, the Health Insurance industry has benefited and will continue to benefit from the efficiency that technology brings to traditionally paper-driven processes. We are all aware of the impact that Healthcare reform bill has had a significant impact on the Health Insurance industry. They are under a great deal of pressure to explore ways to reduce their administrative costs and increase operational efficiency.
Overall, administrative costs of health insurance include the insurer's cost to administer the health plan, the costs borne by employers, health-care providers, governments and individual consumers. Inefficiencies plague health insurance, owing largely to the absence of standardized processes across the industry. To achieve this, industry leaders have come together to establish standards and invest in initiatives to help their healthcare provider partners transition to the next generation of healthcare technology. The move to online services and paperless explanation of benefits are some manifestations of technological advancements in health insurance. Several companies have adopted Toyota's LEAN methodology or Six Sigma principles to improve quality, reduce waste and excessive costs, thereby increasing the value of their plan offerings.
A growing number of health insurance companies have transformed their business systems in the past decade alone and adopted some form of content management to reduce the costs involved in administering health plans. The key strategy has been to convert paper documents and forms into electronic formats, automate the content development process and securely distribute content to various audiences via diverse marketing channels, including web and mobile.
Enterprise content management solutions can enable document capture of claim forms, manage digital assets, integrate with Enterprise Resource Planning (ERP) and Human Capital Management (HCM) solutions, build Business Process Management (BPM) processes, define retention and disposition instructions to comply with state and federal regulations and allow eBusiness and Marketing departments to develop and deliver web content to multiple websites, mobile devices and portals. Content can be shared securely within and outside the organization using Information Rights Management.
At the end of the day, solution providers who can translate strategic goals into solutions that maximize process automation, increase ease of use and minimize IT overhead are likely to be successful in today's health insurance environment.