major health payer

Our client is a major health payer in Western New York, insuring close to 700,000 members. The company has offered services in the region for more than 80 years, including a full line of commercial, individual, and Medicare products.

CHALLENGE

Our client’s goal is to deliver high-quality benefits packages that improve community health, while increasing efficiencies and lowering costs in the process. One obstacle to achieving this goal was the client’s benefits configuration testing process, specifically during high-volume Open Enrollment periods, which required significant resource, time, and financial investments. To execute the testing, the client had to recruit, train, and manage up to 20 new resources during two separate periods annually.

Drawing upon an 18-year history of working together and our software testing expertise, CTG was charged with identifying gaps that impeded overall quality and finding ways to streamline the process, while continuing to meet the highest levels of customer satisfaction.

SOLUTION

To determine gaps in the existing testing model, CTG deployed an onsite Testing Manager to conduct a business process study and gap analysis. CTG and the client then devised a new managed services operating model to address those gaps while increasing quality and efficiency. Workshops were conducted between the configuration and testing teams to ensure everyone was on board, and existing configuration testing automation tools were revamped.

CTG’s streamlined solution has now been running successfully for more than 5 years, leading to a 150% reduction in the overall cost of benefits configuration and testing. This translates to more than $1 million in cost savings per year for the client, and has allowed for additional investment in test automation, further reducing resource needs by more than 70% over the 5-year period. Turnaround time for configuration has been reduced by 80%. Customer satisfaction rating has increased from 3.5 to 4, and the average quality index has improved to 95%.

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