Blue Cross & Blue Shield of Rhode Island (BCBSRI)
Enhance Member Satisfaction Through Integrated IT and Business Process Outsourcing Solutions
When Blue Cross & Blue Shield of Rhode Island began to strategically evaluate how to sustain its competitive advantage, they turned to Perot Systems to lay the foundation required to build a dynamic, consumer-focused company.
The Challenge
Blue Cross & Blue Shield of Rhode Island (BCBSRI) looked at itself during the early stages of implementing its five-year strategic plan and realized that even as a dominant figure in the state of Rhode Island, it still needed to measure itself against the capabilities of major national health insurers. As a result, they embarked on a company-wide transformation to remain competitive.
The company’s strategic mission was to improve the health of its members, strengthen relations with providers, and simplify business processes.
BCBSRI’s senior leadership recognized that a change was needed and the only way to successfully achieve its corporate goals was to incorporate formal structure and processes to ensure projects would be appropriately defined, evaluated, prioritized, and managed.
The Solution
BCBSRI selected Perot Systems over much larger competitors to undertake a major transformational outsourcing initiative. The engagement employs the full array of Perot Systems services, including business process outsourcing, IT outsourcing, application management services, a Digital Health Plan portal, offshore data entry services, and DIAMOND® claims administration software consulting, configuration, and conversion services.
Perot Systems began working with BCBSRI to develop and implement an enterprise-wide Program Management Office (PMO), which provides the organization a framework for instituting the essential processes, tools, disciplines, and governance. Prior to the formal rollout of the PMO, Perot Systems’ project management experts conducted a series of training sessions that provided the organization with an overview of the PMO, along with project management training.
Perot Systems now manages all of BCBSRI's IT and claims transaction processes and is in the process of transitioning the health plan to Perot Systems’ DIAMOND Enterprise core administration platform and supporting products in order to create a strong foundation. This technology conversion will enable the health plan to quickly adapt to changes and lead their market in the introduction of innovative products and services.
The DIAMOND Enterprise platform includes many large, complex technology and business process components. Perot Systems has committed to completing this transformation while maintaining BCBSRI’s long-standing commitment to the Rhode Island community, its associates, and the members they serve.
The Results
“I have never had such a smooth outsourcing transition or seen operational improvement as quickly as I have with Perot Systems,” said David Zink, CIO and Vice President of BCBSRI.
So far, Perot Systems has been able to deliver the following benefits to BCBSRI:
- Provided leadership with a comprehensive perspective on corporate initiatives
- Ensured alignment of projects with strategic goals
- Created an organization-wide project management skill set through ongoing training and mentoring
- Developed customized project management methodologies, processes, and tools
- Ensured initiatives were thoroughly evaluated through the use and development of business cases and cost/benefit analysis
- Developed an online support center to provide access to the various tools and procedures
- Provided centralized tracking and reporting of enterprise project progress through an online program dashboard
- Implemented MACESS, a claims imaging system, two months early and on budget
- Completed technology refreshes on the mainframe, disk storage, and UNIX servers
- Met the first 3 key DIAMOND Enterprise implementation milestones ahead of schedule
- Implemented Perot Systems’ best practices in all infrastructure areas, which has dramatically improved BCBSRI’s perception of the Infrastructure group
“Since Perot Systems came in, we launched a new benefit program called HealthMate Personal Choices, which is revolutionary in our space. This initiative would have never gotten off the ground if Perot Systems had not taken the load off of our shoulders. We are now able to initiate and implement programs we could only dream about before,” said Zink.