Established in 1996, Highmark Inc. ranks among the leading health insurers in the United States and is the largest health insurance company in Pennsylvania based on membership. Highmark is an independent licensee of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans. The not-for-profit health services corporation serves 4.6 million people through the company's health care benefits business and also offers a wide variety of insurance and insurance-related products and services to 24 million people nationwide. 
With health care costs steadily rising, Highmark's customer member community demanded reduced administrative expenses and more convenient choices. Through $200 million in technology investments over the last several years, Highmark has state-of-the-industry electronic enrollment, electronic billing, self-service customer portals and electronic distribution. Unfortunately, only a limited number of customers were using these capabilities. Highmark wanted to address these business challenges through a business process redesign initiative to improve member service and lower the cost of health care to its members.

To take full advantage of its recent technology investments while increasing value for its customers and lowering administrative costs, Highmark with the help of Accenture launched the ePlatform project. The project started with Highmark designing a set of products which encouraged customers to use self-service capabilities. In addition to designing new products, a sales campaign and supporting processes were also developed. Next, Highmark established a dedicated operating unit with streamlined business processes designed to better support the end-to-end customer transaction and encourage use of these self-service capabilities.  

The strategic business goal of the ePlatform project was to use these existing technology investments innovatively to reduce administrative costs and the cost of health care insurance for its customers.

The ePlatform initiative directly supports Highmarks community commitment and mission to provide access to affordable, quality health care, enabling individuals to live longer, healthier lives. Since ePlatform went live in July of 2005, membership has increased from 75,000 members to more than one-million members, lowering staffing ratios by 35 percent and achieving cost reduction savings of $17 million.

The ePlatform project was completely reliant on technology to enable the new product design and streamlined business processes. ePlatform relied on technology to enable self-service at a dramatically increased volume. The project also used some additional technical tools to support the new streamlined business processes.   
Specifically, the ePlatform project took full advantage of the technology investments in electronic enrollment, electronic billing and self-service customer portals:
	Electronic enrollment  Electronic enrollment is facilitated though real-time Internet and dedicated channel transaction-based capabilities. Individuals and smaller customers can interact with Highmark for enrollment functions using Internet-based tools. Larger customers can interact with Highmark for enrollment functions using direct connections between the customers HR systems and Highmarks enrollment system.
	Electronic billing  Electronic billing supports both bill presentation and fulfillment across product lines to allow for multi-product combined bills. This capability is Internet-based and provides a variety of payment and reporting options.
	Self-service customer portals  Self-service portals provide customers with real-time functionality so that customers can better manage their health care and related financial transactions. Real-time access is provided through service oriented architecture-based services used by all customer-facing systems. The answer provided to a customer is consistent whether a customer calls a service representative, looks up information through the portal or receives an answer from an interactive voice response system. See appendix 1 and 2.
As this project dramatically increased the number of customers using self-service channels, it was important to help ensure that these systems were scalable. The Web architecture used is highly scalable and built on a services-oriented framework consisting of mainframe and open systems servers. Core information is accessed primarily from DB2 or Oracle data through services running in a clustered Websphere Application Server environment.  All transactions consist of real-time access to a majority of the companys operational data in less than five seconds on average. Given the flexible architecture on which these self-service channels were built, Highmark easily scaled them to handle the dramatic increase in volume.
Highmark also developed essential technology tools to support the new processes:
	Workforce Management - A workforce management tool was implemented to develop more accurate call forecasting, enable real-time scheduling, and reduce over- and under- staffing.
	Avaya Desktop Wallboard - A customer relationship management desktop "ticker tape" tool that scrolls real-time phone statistics as well as customizable messages was used to dynamically reassign staff to handle spikes in call volumes.
	Inventory Control Tool  A custom application was developed to more closely track and manage the work involved in setting up new customers. 
	Virtual Corridor  Accenture Technology Labs installed always-on videoconferencing between ePlatform's two geographically separated service centers to facilitate real-time communication between the two centers
These various technologies enabled the ePlatform project to lower staffing ratios by 35 percent and the costs of health care insurance for its customers.

Yes

Yes

A shared value proposition between Highmark and its customers, the ePlatform initiative fully reflects Highmark's innovative approach to customer relationship management. The ePlatform initiative positions its customers as partners in changing business processes to streamline the interaction between them. The initiative directly supports Highmarks community commitment and mission to provide access to affordable, quality health care, enabling individuals to live longer, healthier lives. Customers agree to a set of standard benefit options and to use the self-service channels in exchange for sharing the cost savings made possible by the change in behavior.
The self-service capabilities are designed to take full advantage of Highmarks existing technology assets around electronic enrollment, electronic billing and self-service portals to lower the associated administration costs, such as staffing, paper, printing and distribution. These savings are then passed on to customers in many cases in the form of premium reductions.  

Since ePlatform went live, Highmarks membership base has increased from 75,000 to over one million, lowering staffing ratios by 35 percent and achieving cost reduction savings of $17 million. In turn, Highmark has successfully reduced the cost of health care to the community it serves. In addition, Highmark has developed a differentiated productwhile minimizing the need for further investments in technology and systemsand is well positioned to sustain high performance in a challenging and rapidly changing health care market place.

Highmarks customers ultimately benefit from the different options available with ePlatform and the wider range of product offerings tailored to specific requirements. The customers experience of increased responsiveness to their individual needs has resulted in Highmark achieving and/or exceeding customer service expectations. 
ePlatform aligns Highmark with the growing number of customers who are eager to embrace technology as a lever for improving service. Examples of improved service include faster and more accurate inquiry response times, more timely and accurate billing, and wider use of Web tools for routine activities.
"The online services provided through ePatform allow us to save time and more efficiently manage our health care coverage," said Wendy Ebersole, human resources director for Kinsley Construction, a construction management and full-service general contracting firm, which has 2,800 employees. "In addition, it gives our employees a convenient way to handle their coverage and make informed, appropriate care decisions."

Though ePlatform, Highmark formed an innovative partnership with its customers.  Highmarks customers became partners in streamlining business processes to reduce unnecessary administrative cost for both themselves and for Highmark.

The ePlatform project provided Highmark an innovative way to improve performance and lower the costs of its operating environment for a large portion of its membership. The initiative was all about driving business process changes into Highmarks operating units and customer base to help maximize and expedite the return on its recent investments in technology and core systems. In turn, these savings contribute to Highmarks ability to reduce customer premiums and increase market share and retention. 

In the past few years, Highmark has invested more than $200 million in technology to improve customer service and reduce administrative costs. With health care costs continuing to rise, Highmarks customers are demanding reduced administrative expenses and more convenient choices. This project used existing technology investments in an innovative way to reduce Highmarks administrative costs and the cost of health care insurance for its customers.

Highmark designed a new insurance capability and dedicated a new operating unit that could fully use existing technology to obtain a competitive cost advantage. Specifically, Highmark created a new set of self-service enabled products which took full advantage of Highmarks existing assets around electronic enrollment, electronic billing, customer portals and electronic distribution of materials. These new products were structured to encourage customers to use the self-service and electronic transaction capabilities that had been developed over the years.

Highmark also created a new operating unit with streamlined business processes to support these self-service enabled products. This new operating unit supports end-to-end, back-office processing, including enrollment, membership, customer service, claims payment and billing. The business processes in this unit were designed to take full advantage of Highmarks existing electronic capabilities. These processes were streamlined to eliminate unnecessary steps when supporting the new products.  

Innovatively packaging Highmarks advanced electronic capabilities through the launch of ePlatform helped the company obtain substantial value from its technology investments. Most importantly, the project helped Highmark improve its competitive position in the market and deliver substantial cost reductions to customers. 

The ePlatform project faced three major difficulties or risks to overcome:  

	First, the ability to attract customers to a self-service product.  
	Second, the ability to support these new products with 30-percent fewer staff.  
	Third, the ability to successfully scale the portals and other technologies required to support these self-service products.

There was a risk that customers would not be attracted to the new ePlatform self-service product. This risk was mitigated by providing a financial incentive for customers to buy the new product, deploying product specialists with targeted sales messages and establishing financial rewards for the sales force. In effect, the number of members buying these products has increased from 75,000 to over one million. 

One of the original goals of this project was to lower administrative costs by reducing the number of staff required to support these new products by 30 percent. The administrative efficiencies were targeted from a variety of different sources. While the operational unit targeted savings from the use of self-service channels, it also targeted savings from product standardization, process redesign and improved performance management. In addition, Accenture co-managed the operational unit for the first year of operations and brought operational and performance management best practices from outside the health insurance industry. As a result, ePlatform has exceeded the original goal of supporting these products with 30-percent fewer staff. The ePlatform products are currently being supported at the same or better service levels with 35-percent fewer staff.

As this project dramatically increased the number of customers using self-service channels, it was important to help ensure that these systems were scalable. Core information is accessed primarily from DB2 or Oracle data through services running in a clustered Websphere Application Server environment. All transactions consist of real-time access to a majority of the companys operational data in less than five seconds on average. Given how the services-oriented framework was designed and built, the self-service channels were scaled to handle the increased volume without any service disruption or degradation.

The ePlatform project met resistance from Highmarks customers and operations staff. One of the principles of ePlatform was transitioning customers from paper-based to electronic-based transactions--some customers resisted the change. Several different techniques were used to help customers make the transition:
	Explanation of the shared value proposition  Customers were much more open to change once they understood the purpose of the change, and how they would benefit. Highmark described the transition away from paper-based transactions as something that was being done with the customer not to the customer and as an opportunity to help lower customer costs.
	Financial incentives  Some customers were given a financial incentive to move to electronically-enabled ePlatform products.  
	Phased approach  Allowing customers to phase-in their migration to paperless transactions also increased acceptance of the change. Customers were given the flexibility to migrate their various paper-based transactions to electronic transactions in stages--with the agreement that they needed to be fully paperless within one year.
	Address objections in person  Given the large number of customers impacted, most of the ePlatform communications were one-to-many rather than one-to-one. However, strategically deploying the sales staff to address customer objections in person proved invaluable.  
These techniques were very successful in increasing customer adoption of paperless transactions. However, once customers were convinced of the benefits, it took some work to convince Highmarks internal operations staff of the benefits. There are several operational areas within Highmark, and the operational areas competing with the ePlatform operational area were skeptical that the same work was being done with 35-percent fewer people. To eliminate this skepticism, Highmarks finance department was given responsibility for measuring savings. Having an impartial third-party measure benefits was invaluable in eliminating skepticism of the results achieved.

Exceeded

The ePlatform initiative directly supports Highmarks community commitment and mission to provide access to affordable, quality health care, enabling individuals to live longer, healthier lives. Through the initiative, customers agree to a set of standard benefit options and to use the self-service channels in exchange for sharing the cost savings made possible by the change in behavior. By working together with its customers, Highmark is working to reduce the cost of health care not only for them but also for the communities it serves. 

Helping communities achieve better health has been at the heart of Highmarks mission since the 1930s. That commitment was especially evident in 2008 when the company provided more than $9.8 million to support health initiatives that benefitted thousands of Pennsylvanians. While the company seeks to find ways to save costs for its members through such initiatives as ePlatform, Highmark also supports efforts that improve access to health care for individuals who are underserved, underinsured or uninsured.  

In addition, Highmark provides funding for programs focused on prevention and wellness. The company supports childrens health initiatives to fight obesity and build a foundation for children to enjoy healthier lives in the future. The company is also committed to supporting endeavors that foster strong families. For more information on Highmarks community support efforts, visit its Web site at www.highmark.com.

Highmarks customers have aggressively adopted the ePlatform products and value proposition:
	Within seven months of the January 2005 project launch, the ePlatform operating unit was up and running, supporting 75,000 Highmark members.
	Within just one year, the ePlatform membership base of Highmark had approximately tripled, and the new ePlatform operating unit was demonstrating a higher-level of efficiency.
	Within three years, the ePlatform membership base has grown from 75,000 to more than one million, and Highmark is supporting its products with 35-percent fewer staff.
	Highmark has not only achieved but exceeded its targeted 30-percent administrative savings goal.