Webinar: Leading Healthcare Insurer Saves Time and Costs

25
Gregory Barnowsky Case Study: Independence Blue Cross Mobility Project Chief Architect of Enterprise Architecture at Independence Blue Cross Jeffery Kendall Director of Healthcare Sales at Kony

description

Chief Architect of Independence Blue Cross, Gregory Barnowsky, discusses their mobile strategy from discovery to implementation.

Transcript of Webinar: Leading Healthcare Insurer Saves Time and Costs

Page 1: Webinar: Leading Healthcare Insurer Saves Time and Costs

Gregory�Barnowsky

Case Study: Independence Blue Cross Mobility Project

Chief�Architect�of�Enterprise�Architecture�at�Independence�Blue�Cross

Jeffery�KendallDirector�of�Healthcare�Sales�at�Kony

Copyright�©�2010�Kony�Solutions,�Inc.��CONFIDENTIAL 11

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I d d Bl CIndependence�Blue�Cross�and�the�Kony Partnership

June�2012�Greg�Barnowsky�

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Topics….

• Independence�Blue�Cross�– Company�Overview• Our�Mobile�Technology�Strategy• Our�Business�Vision�of�Mobility�in�Healthcare• Selecting�a�Mobile�Vendor�/�Partner�– Kony• Key�Considerations��when�selecting�a�Mobile�Vendor�Technology�Provider

• Our�current�Technology�Implementation�Approach• Current�Status�of�our�Mobility�and�Kony Applications

• Examples

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Independence�Blue�Cross�– Company�BackgroundBackground

• Philadelphia�based�member�of�the�Blue�Cross�and�Blue�Shield�A i iAssociation— Corporate�Mission:�To�enhance�the�health�and�wellness�of�the�people�and�

communities�we�serve�by�increasing�access�to�quality�healthcare�and�d li i l th h d t d idelivering�value�through�our�products�and�services

— Membership�~ 3 Million mostly�across�5�southeastern�PA�counties;�with�subsidiary�businesses�in�NJ�and�DE

— Product offerings for all segments of the marketplace including: Managed— Product offerings�for�all�segments�of�the�marketplace,�including:�Managed�Care�(HMOs�and�PPOs),�Medicare,�Medicaid,�CHIP�(Children’s�Health�Insurance�Program),�and�Traditional�

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Our�Mobile�Technology�StrategyCHOOSING THE RIGHT SOLUTIONSCHOOSING�THE�RIGHT�SOLUTIONS

• Challenges�Overcome�Costs�� • Investments�Considered��

Environmental�and�Internal�Hurdles

�Without�HTML�5.0�adoption,�top�U.S.�Smartphone�application�environments�vary�widely�in�capabilities�and in development tools and licensing*

Technology GAPS�to�Address

�New�Infrastructure�Support�Middleware�support�to�manage�the�device�access�to�backend�data�and�

li ti i l di dditi l b iand�in�development�tools�and�licensing*�

�Technology�tools�vary,�infrastructure�toolset�required,�security�and�data�management,�backend�host�integration�capabilities,�support�for�IBC�current�t h l d ti l i t

applications�including�additional�web�services�capabilities,�

�Updated�security�monitoring�upgrades�to�provide�remote�wipe�and�other�capabilities�such�as�member�l i d th ti ti i ttechnology�and�operational�environment

�Rapidly changing�market�in�device�capabilities,�applications,�and�technology�toolset�and�network�&�middleware�capabilities

login�and�authentication�services,�etc.

�New�Training, and�focus�to�“build�rapidly�internal�delivery�capability

�R l GAPS i R d S l i B l d�Investment�in�skillsets,�and�mindset�to�best�address�the�Smartphone�technology�is�needed�(e.g.�new�market�includes�gaming�features,��GPS,�integrated�voice�recognition,�mapping,�search,�telephony,��

bili )

�Resolve�GAPS�in�Resources�and�Solutions�Ͳ Balanced�delivery�capability�between�internal,�external�or�Third�Party�Solutions�and�External�Staff�augmentation

�Address�Ͳ Cost�Effective�Mobile�Development�mobility,�etc.�etc.�etc.) technology�toolset

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Our�Business�Vision�of�Mobility�in�Healthcare

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Our�Business�Vision�of�Mobility�in�Healthcare

The Basics: mHealth: Gamification:The�Basics:Customer�Service,�Administration

mHealth:Wellness,�Medical�Management�

Gamification:Marketing,�Sales,�

Wellness

Mobile�Member�Portal�for�

Exercise,�Nutrition,�and�

Game�Apps�to�Gain�Market�

Customers Tracking�Apps Attention

Apps to Engage

Apps�for�BrokersMobile�

Connected�Devices

Apps�to�Engage�Members�and�

Reward�BehaviorsBehaviors

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Our�Business�Vision�of�Mobility�in�Healthcare

The Next-Gen Mobile Insurer: K A d F ti litKey Apps and Functionality

mHealthGamification

Customer�Service�and�Administration Common�Themes

Rapid�InnovationChannel�IntegrationEase�of�Use,�UsabilityCustomer�Engagement

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Selecting�a�Mobile�Vendor�/�Partner�– Kony….

• Key�Capabilities�of�Mobile�Develop�ToolsetS f HTML 5 0• Support�for�HTML�5.0

• Cross�platform�support• Security�• Integration�with�IBC�Operating�Environment

• Portals,�transactional,�datawarehouse,�and�internal�corporate technology (e g SharePoint)corporate�technology�(e.g.�SharePoint)

• Support for “games” and high-localized performance• Partnership and vendor viability

• Rigor – Followed IBC Technology Selection ProcessRigor� Followed�IBC�Technology�Selection�Process• 40+�vendors�evaluated�initial�“pool”�• >�1�year�duration�(longest�on�record)

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The�KONY�CoE Ͳ Fast,�Agile�and�CostͲeffect�mobile solutionsmobile�solutions

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Building�Kony Applications

• Current�activity¾ I i i l P l d¾ Initial�Prototypes�completed�

— <�90�days�for�feature�releases— Launching�our�Member�Mobile�Release�2.0�w/�Kony team— Agile�Methodology�— Linked�to�IBC�Strategic�and�Business�Development�group

• Lessons Learned• Lessons Learned¾ Take Center of Excellent (CoE) approach

— Application Architecture is a great start for these skills¾ Utilize Agile Methodology¾ Utilize Agile Methodology ¾ Start small – revamp an existing mobile app and re-platform to Kony¾ Don’t forget your partner? Leverage KONY Support!

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Current�IBC�Kony Applications

EXAMPLESEXAMPLES

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Payment�Reminders�Application�

DescriptionPayment�reminders�to�help��members�to�keep�track�of�their�bill�payments�and�due�dates.��

Benefits / Features SolutionBenefits�/�Featuresy Display�a�calendar�with�the�due�date�

highlighted�for�each�month�y Notify�the�member�in�advance�when�a�bill�is�

Solution

due�by�displaying�an�alert�on�the�application�icon

y When�payment�is�overdue�the�application�icon�color�can�change�to�red

Reminder MBR�CRM

y Display�the�payment�amount�and�coverage�period�dates

y Display�payment�history�information�such�as�the�transaction�date,�the�amount�and�the�

Kony

Payment

MBR�Contact�Mgr

status�(paid)

Payment�Notice eBilling (eBB)Event�Mgr

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Doctor,�Pharmacy�and�Hospital�Finders�

DescriptionD Ph d H i l Fi d hi l di i dDoctor,�Pharmacy�and�Hospital�Finders�– graphical�directions�and�nearest�locations�with�match�to�current�Member�Profile�and�Preferences�for�Health�Products. Solution

Benefits�/�Featuresy Profile�based�fast�location�servicesy Formulary finders/ 24 hour pharmacyy Formulary�finders/�24�hour�pharmacyy Emergency�service�and�nearest�ED�(for�

out�of�town�emergencies)y Rank�locations�by�cost�and�quality�

locationy Customized�search,�incentives,�and�

“healthy�workout�locations”�– (e.g parks,�swimming areas, etc.)

•Location�history•Average�Speed•Previous�Rewards

•Location�history•Average�Speed•Previous�Rewardsswimming�areas,�etc.)�

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Enhanced�Fitness�and�Personal�Health

DescriptionAllow members to search for fitness centers check in for workouts andAllow�members�to�search�for�fitness�centers,�checkͲin�for�workouts,�and�enroll�in�the�Healthy�Lifestyles�Fitness�Program.�Log�visits�to�the�gym�using�GPS�tracking,��which�counts�towards�the�members’�discount�program�for�reimbursement.�

Solution

Benefits�/�Featuresy Fitness�Center�Search�– search�on�fitness�

SolutionGPS�GeoͲfence

center,�address�or�zip�and�state�or�using�current�GPS�location

y Fitness�status�to�display�on�app�–Current/anniversary�dates,�number�of�visits,�

• Healthy�Lifestyles�Rewards

• CheckͲin�status• Fitness�data

Fitness�Center

/ y , ,days�remaining

y CheckͲin�using�GPS�location�to�any�participating�gym.��Save�member�data�locally�so�no�need�to�keep�reͲentering�it�(Pin,�USI,�p g ( , ,etc.)

15

Fitness�Center�Search

Member�Data

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Kony�Overview

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Who�uses�Kony

3�of�the�top�6�U.S.�automobile�brands

3�of�the�top�5�largest�insurance�companies

3 of the top 5 largest passenger airlines in the U S3�of�the�top�5�largest�passenger�airlines�in�the�U.S.

2�of�the�top�3�banks�in�the�U.S.

2�of�the�top�6�largest�auto�insurance�companies

17Copyright�©�2012�Kony�Solutions,�Inc.��CONFIDENTIAL 17

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Value�to�Payers�for�Mobile�Apps

� Member�ID�Cards:� On�average,�a�replacement�member�ID�card�is�$5.00Ͳ

7.00�per�card�� PBM�Functionality� Allowing�patients�to�request�mail�order�online�can�

increase net profit of about $10 00 per 90 day fillincrease�net�profit�of�about�$10.00�per�90�day�fill.� Reducing�Call�Center�Interactions� Reduce�cost�by�$12Ͳ15.00�per�call

� It’s�in�the�RFP’s!� Companies�such�as�Google,�Intel�and�others�have�

placed�REQUIREMENTS�for�mobile�access�in�their�search�for�a�new�health�plan

� Healthcare Reform� Healthcare�Reform� In�2014�Health�Insurance�Exchanges�will�drive�more�

needs�for�consumerization�of�health�plan�purchasing.

18Copyright�©�2012�Kony�Solutions,�Inc.��CONFIDENTIAL 18

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Example�Payer�Use�Cases�for�Mobility

� Member�Facing�Apps� Member Cards

� Employee�Facing�Apps� HR Mgmt� Member�Cards

� Rx�Management� Claims�Management

W ll / Adh

� HR�Mgmt� Corporate�Intranet� Closed�Loop�Feedback

SFA / CRM� Wellness�/�Adherence� Plan�Compare�/�Shop� Cost�Estimation

� SFA�/�CRM� Broker�/�Enrollment

� Provider�Facing�Apps� Formulary�Mgmt� Claims�Status� Cost�Estimation� Pay for Performance

19Copyright�©�2012�Kony�Solutions,�Inc.��CONFIDENTIAL 19

Pay�for�Performance

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Paths�to�Success

Custom�B2C,�B2E�App

Configurable�preͲbuilt appsg p pp

MultiͲChannel�EnterpriseApplication�Platform�(MEAP)

20Copyright�©�2012�Kony�Solutions,�Inc.��CONFIDENTIAL 20

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KonyOne�MultiͲChannel�Platform

KonyOne Server

� Lightweight�orchestration

KonyOne Studio

� Standards�Based�Eclipse�Plugin

Kony�MultiͲChannel�Application�Management

g g� Mobile�optimized�

transport/messaging� Enterprise�connections� Device�database�(9000+�devices)� Logging�&�Analytics

P h N ifi i

p g� Javascript &�Lua based� Define�and�test�mobile�apps:

� Drag�and�drop�widgets�� Customize�widgets�to�specific�

device,�iOSD fi

Server�Side� Assign�policy�to�apps� Test�&�deploy�apps�to�app�

store� Assign�User/Group�to�app

� Push�Notifications� Define�events� Connect�to�backend�services�

and�data� Preview�on�the�fly

� Generate�apps�for�channels� Test with emulators and devices

� Send�notifications�to�app� App�analytics�&�reporting

Client/Device�Side� Secure�device�container�� App store app

Only�Kony…Only�Kony… Only�Kony…

Test�with�emulators�and�devices App�store�app� Policies�enforced�at�run�time

DEVELOP������������������������������������DEPLOY���������������������������������MANAGE

� Supports�BYOD�for�all devices� Offers�softly�partitioned�app�

container�on�device�for�security� Delivers�centralized�console�for�

management�of�server,�sync,�apps

� Supports�multiͲchannel�development�within�code�base

� Supports�7�native�OSs�+�HTML5�Hybrid�&�Mixed�Mode

� Delivers�standardsͲbased�HTML5�APIs

� Offers�integrated�B2C,�B2E�server� Provides�loosely�coupled�architecture�

and�lightweight�middle�tier� Supports�integrated�data�and�SMS�

synchronization

21Copyright�©�2012�Kony�Solutions,�Inc.��CONFIDENTIAL 21

pp

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Kony�PreͲBuilt�Apps

Feature�Complete9 Leveraging�industry�experience9 Hundreds�of�use�cases�per�app

Configurable9 Make�changes�without�rebuilding�or�republishing9 Enable/disable�features�and�rulesp pp

Extensible9 Add�custom�or�3rd party�modules9 Support�businessͲspecific�requirements

Universal�Connectivity9 Standards�based�connectivity�via�Web�Services�(Rest�or�

SOAP),�JSON,�Java�connectors�or�website�data�Scraping9 Connectors�to�SAP,�Oracle,�Siebel,�and�other�legacy�

systemssystems

22Copyright�©�2012�Kony�Solutions,�Inc.��CONFIDENTIAL 22

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Empowering�Members Everywhere:�Health�Plan�App

Medication�SearchNew�RevenueResearch�medications�and prices

Research�and�shop�for plans and�prices

Request�and�get�an�instant�quote�

for�plansSave�search�

results�

Provider�Rx�ePrescribe

Rx�conversion�

Rx�journal�and�reminders

Plan�InfoFind�Facility�/�Provider

Contact�a�representative�

opportunities

Find�providers�(geoͲbased�locator)

View/track�all�claims�by�plan�member

View�benefits�information�by�member�

Find�facilities�(urgent�care pharmacy)

Research�symptoms�and�conditions�

Graphical�3D�ID�Cards�(view,�eͲmail�or�print)

Plan�expense�summary�

Account�balance�

care,�pharmacy)

Filter�and�sort�results�by�specialty,�type�and�distance

23Copyright�©�2012�Kony�Solutions,�Inc.��CONFIDENTIAL 23

Contact�and�schedule�appointments

details�

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KonyOne�SLA:�Future�Proofing

Today

Kony�Platform�Version 3.0 3.5 4.02.5 4.5 5.0 5.5 6.0 6.5

4.x 5.xToday

3.0 4.02.3

6.0.0 7.0.0Kony�has�you�coveredOS�Upgrade�– 30�days*

New�Device�on�New�OS�– 90�days*7.0 8.0

1 0

*�from�release�to�developers

24Copyright�©�2012�Kony�Solutions,�Inc.��CONFIDENTIAL 24

1.0

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Q ti ?Questions?

More information on www.kony.com/[email protected]

Copyright�©�2010�Kony�Solutions,�Inc.��CONFIDENTIAL 2525