Challenge: After years of rapid growth, Humana’s provider data was housed across multiple systems and locations, posing challenges to data analytics and effective resource management.
Solution: Initiate software is enabling Humana to link records across a variety of systems for a multitude of initiatives, including provider data maintenance, provider customer service and provider analytics.
Humana is one of the nation’s largest publicly traded health and supplemental benefits companies, serving 11.4 million medical members across a network of more than 550,000 physicians, hospitals, pharmacies and ancillary care providers in almost every state. Humana leads the industry in the healthcare consumerism movement, delivering more affordable healthcare through its unique guidance solution to produce lower costs and a superior experience for the consumer.
To best achieve the goal of engaging consumers, Humana has pursued innovative means of maximizing the value of its data in all areas of business, including provider data.
The Challenge: Improve Provider Information Management Over the past few years, Humana’s engagement of consumers has proved successful, resulting in rapid expansion and increased satisfaction of its members. In the face of this unprecedented growth in membership, Humana needed to wisely and innovatively use resources to manage the growth and complexity of provider data.
As a result of rapid organic growth and some acquisitions, Humana housed provider data across multiple systems and locations, with different systems handling claims, contract information, credentialing and provider directory data. Looking ahead, Humana realized that a new approach toward provider information management would enable operational and customer service enhancements while creating the capability for revolutionary improvements in the future – all at an affordable cost.
Selecting Initiate Systems
With Initiate Systems, Humana chose a solution that met their needs for accurate, real-time linking of provider information housed across the enterprise without disrupting the existing IT environment. With Initiate’s solution, Humana proactively manages vast amounts of provider information across multiple systems, while also enabling a single, complete view of each provider.
Initiate’s software solution has enabled Humana to meet key operational and strategic objectives in three key areas:
- Provider Data Maintenance – A custom workflow system uses Initiate’s solution to enable simultaneous updates of multiple provider data systems, resulting in productivity, accuracy, and speed improvements.
- Provider Customer Service – Customer Service can access a virtual, complete view of provider data from multiple systems in one, coherent provider data console. This enables better customer service because of the complete and accurate view of provider data that can be quickly retrieved.
- Provider Analytics – With a vast range of provider data available through Initiate’s solution, Humana can more speedily answer critical business questions and adapt to changing marketplace needs.
Looking Ahead
Humana has long been at the forefront of healthcare benefits innovation. By applying its innovative approach to Initiate’s solution with provider data, Humana has creatively and resourcefully met operational and strategic requirements. Future plans include extending the gains made into new areas of the enterprise, laying the groundwork for continued productivity, accuracy and speed improvements. With a solid foundation for provider data based on Initiate’s software, Humana is well positioned to continue delivering on its core promise of guidance to consumers and its status as preferred payor with providers.
