The Challenge: Manual Document Creation
Every health plan company is required to submit documentation to the government about the insurance plans it is offering for the upcoming year. For a midwest-based plan, the process to generate this documentation occurred through multiple adjunct tools and workarounds such as email, Excel, and Word, which was time-consuming, manual, and inefficient. They wanted to find a way to streamline and automate document generation for the user groups by removing a need for gatekeepers and human choke points. With a lot of manual steps for creating documentation, the risk for error was high with serious consequences such as selling incorrect plans, not getting government approval, or potential auditing failures. They needed a single source of truth to track versions and accurately generate regulatory documents during the plan creation process.
The Solution: Single Source of Truth for Health Benefit Data
The managed care company partnered with 1904labs to design and develop a web application that acts as the single source of truth for health benefits. The new app allows various teams to view and manage benefits every year, generate the required documents that are filed to the state and federal bodies for approval, and create internal reports. The vision for this internal platform is to be able to scale in order to meet the growing demands of the business and respond to the needs of the users.
Our Process: Human-Centered Design Agile
Using our HCDAgile process, we worked closely with the managed care company to understand the needs of the teams involved. With that input, we worked with them to create a solution customized to user needs and scalable to meet the growing demands of the business. We worked with three key teams: the product development team that creates the benefit products, the regulatory operations team that enforces government regulations around those benefits, and the product administration team that finalizes plans and interfaces with the government. By focusing on the needs and challenges of each team, we built an internal system that allows for benefits data to move in an automated way.
Click to view the full size As-Is Journey Friction Meter
I feel like the team did a really good job listening and understanding what we want, which is refreshing.
- Business Director, Managed Care Organization
The Outcomes: Enhanced Speed and Efficiency
Significantly faster document creation
Previously, the document creation process required an immense amount of manual processes that was time consuming and error prone. Now, the teams can manage yearly benefits and create documents and reports in a more efficient, automated way through a unified web app. A process that previously took weeks now takes days. Removing gatekeepers and process inefficiencies allows the managed care company to significantly streamline the document creation process.
More visibility with a single source of truth
The new application created one consolidated location for all necessary teams across the company to collaborate on benefits plan details and related documentation. It eliminates manual processes and work done in Excel and Word and shared over email. Removing previous dependencies on single individuals for accurate information, the application instead houses all past data in one central, collaborative location.
Increased efficiency with new features
New tools enable easy editing across 3,500 plans through bulk editing features. With variations of a plan, you can change all variations at once which was previously done individually. Employees can also now generate all documents for submission at one time (such as all federal and state regulatory documents across plans). The new solution removes replication, the potential for human error, and allows the managed care company to grow into more markets faster.
Click to view the Journey Map of Docs and Template Submissions (To-Be)