Neighborhood Health Plan (NHP), a not-for-profit health maintenance organization, serves more than 200,000 members in Massachusetts, the first U.S. state to mandate universal healthcare coverage. In an effort to streamline its architecture and develop insights into its performance, NHP implemented a Microsoft® Business Intelligence solution to improve analytic and reporting capabilities. As a result, NHP has saved U.S.$2.2 million in consulting costs and $100,000 in software licensing, is meeting the increased demand for data, is efficiently managing membership growth, and has freed up analysts to enhance competitive advantage.
In 2007, the Commonwealth of Massachusetts mandated that all residents obtain healthcare coverage or face tax penalties. Neighborhood Health Plan (NHP) was one of only two health plan providers licensed by the state to participate in both the Commonwealth Choice (brand-name health insurance) and Commonwealth Care (low or no-cost insurance for people who qualify) product offerings. In the Commonwealth Choice offering, NHP competed with much larger organizations and needed to add and serve members and healthcare providers quickly in order to be competitive. “From December 2006 to December 2007, we experienced 22 percent membership growth,” says Marilyn Daly, Chief Information Officer for Neighborhood Health Plan.
Because of the expanded healthcare program, NHP faced increased regulatory reporting requirements as well as greater demands for information by healthcare providers and NHP analysts. Further complicating matters, in 2007, NHP also was implementing a new core administrative transaction system, replacing four previous transaction systems, to support the health plan’s operations. Employees struggled with learning the best way to extract information from the new transaction system because NHP was using multiple business intelligence (BI) tools. “Our three different reporting tools produced different results,” says Daly. “We spent an excessive amount of time analyzing the data for accuracy.”
NHP struggled to keep up with information requests. As the changes to state healthcare were implemented, the demand for information was growing at a pace that the current reporting process and multiple tools could not sustain successfully. It often required eight weeks for a programmer to write, test, and validate queries before releasing to production. Analysts spent valuable time requesting and validating data, rather than analyzing data to make informed decisions and move the business forward. With no system for cataloging data requests, new queries were written for each request, rather than modifying previous requests.
Meanwhile, NHP was using IBM WebSphere software for its intranet and healthcare provider portal, Novell SilverStream for its public Web site, and IBM Lotus Notes for e-mail. As part of a previous move to TriZetto QNXT for claims processing, NHP began using Microsoft® SQL Server® 2005 for its data warehouse.
“We implemented new systems, we are getting more and more requirements for reporting, and our membership is skyrocketing—it’s a perfect storm,” says Daly. “We needed to deemphasize the focus on technology and instead focus on collaboration and using information more strategically.”
Daly turned to Microsoft Certified Partner Accelare for help. Mark McCormick, President of Accelare, told Daly that Neighborhood Health Plan had too many products to integrate and too many vendors to manage, and desperately needed to simplify its architecture. “NHP already had a data warehouse system based on Microsoft SQL Server,” says McCormick. “By eliminating WebSphere and the other products and moving to Microsoft software throughout its network, NHP could ease the tasks of extracting, publishing, and distributing information without having to worry about integration.”
||In 2008, we spent $2.2 million on consultants to create reports; in 2009, we’ve spent nothing in that category…. My chief financial officer is pretty happy about that outcome.
Chief Information Officer, Neighborhood Health Plan
NHP qualified for a Microsoft Volume Licensing Enterprise Agreement, which would cover the Microsoft products that NHP already licensed plus Microsoft Office PerformancePoint® Server 2007 (now part of Office SharePoint® Server 2007), Office SharePoint Server 2007, and Exchange Server 2007, at a significant cost reduction.
To disseminate information more efficiently, Accelare moved the NHP public site, intranet, and healthcare provider portal to Office SharePoint Server 2007. NHP later created an online tool for the provider portal, automating the process of adding new providers to the network.
NHP also deployed SQL Server 2005 Reporting Services, Analysis Services, and Integration Services to address internal and external reporting needs, eliminating the need to create brand-new reports to meet every information request. Combined with Office SharePoint Server 2007 and PerformancePoint Server 2007, NHP now has a streamlined solution to access and present data accurately and rapidly, all in a user-friendly format. “Using Microsoft Business Intelligence, NHP now has approximately 300 standard reports and report templates that were built once and are being used over and over again,” says McCormick.
With the new BI solution, NHP employees can access data and information specific to their needs through familiar tools. “We are working toward an 80 percent self-service model for reporting,” says Daly, “with only 20 percent of our reporting needs requiring IT resources.”
Thanks to its integrated solution, Neighborhood Health Plan has improved business intelligence capabilities, resulting in benefits for the organization, employees, and healthcare providers.
“In 2008, we spent $2.2 million on consultants to create reports; in 2009, we’ve spent nothing in that category,” says Daly. “I have money budgeted for the sake of caution, but we haven’t touched it. My chief financial officer is pretty happy about that outcome.” Also, costs per transaction are dramatically reduced, in part because the integrated solution lowered administrative and support costs.
The organization has saved money with its licensing as well. “We were able to [acquire] an entire Microsoft solution for 400 employees for what we previously paid IBM for just its WebSphere Portal,” says Daly. By consolidating its IT architecture on Microsoft software, NHP is saving more than U.S.$100,000 per year in software licensing fees.
Improved Data Access and Reporting
During a time of rapid change in healthcare, NHP has been able to increase its membership by double-digit percentages annually, manage information for 9,000 providers, and fulfill its regulatory requirements because analysts and providers now have access to accurate data and forms to make more informed decisions. Authorized NHP users access information easily using a Web browser.
In addition, NHP has improved data quality with automated data entry processes and the elimination of multiple reporting tools that produced different results. Now that NHP has standard, reusable reports set up, employees are using the self-service tools to fulfill their needs. New report requests can be fulfilled in a few days rather than weeks.
Ability to Manage Growth
Although NHP is a smaller health coverage provider, more Commonwealth Choice members selected NHP than some other, larger providers. “In December 2007, our total membership was about 172,000 members,” says Daly. “As of July 2009, we have over 200,000, and we’re still growing.” With more efficient business intelligence processes and better access to information, the plan handled its membership growth and associated reporting requirements smoothly without adding employees.
Enhanced Competitive Advantage
With its new simplified environment, NHP is able to rely on its data integrity, reduce utilization costs, respond to state requirements more quickly and easily, and more effectively negotiate with providers. The organization is also using employee time more strategically. “Our analysts aren’t spending their time validating data anymore,” says Daly. “We’re now using the analysts to help us improve and grow our business, which gives us a competitive advantage.”
Microsoft Business Intelligence
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