Document Agility is Critical for Health Insurers

By Kevin Craine

It’s hard to believe that it was more than four years ago that President Obama finally signed the Patient Protection and Affordability Act (H.R. 3590) – also known as “Obamacare.” While pundits on the right and left continue to argue the potential implications, one thing is clear: the business of health insurance has changed dramatically. The elimination of pre-existing conditions, the expansion of Medicare into rural areas, and broader coverage for both young adults and early retirees are just a few of the impacts. Through it all, the demand for transparency and tighter medical loss ratio requirements continues to transform the way the industry does business.

The Impact on Member Correspondence

The full impact of healthcare reform on insurance providers has yet to be seen, but we can be sure that the process to create and produce member correspondence has been greatly impacted. The volume of communications has risen sharply in order for companies to respond to the many market changes. Member correspondence requirements have become increasingly demanding as plan structures evolve and insurers initiate new systems, products and processes to appropriately comply with the new legislative changes. The pressure for cost containment is intense as insurers react, often rapidly and without a great deal of clarity, to the new demands in the market place.

Document Agility

Companies can respond to these implications in two ways: with great efficiency or with great inefficiency.  Many health insurance organizations struggle to respond due in large part to the current state of their member correspondence systems. Making even the smallest change on a member statement, for example, can take weeks or months. What is needed is greater “document agility.” Companies that continue to use legacy computing systems that are siloed within arcane IT departments will find it difficult, if not impossible, to appropriately respond to the new legislative requirements. Business units that are un-empowered, or who must rely on makeshift homegrown approaches, will quickly fall behind. Overly complex systems that fail to support the rapidly evolving needs to retool will be an Achilles heel for even the most sophisticated enterprise.

New Tools, New Abilities

There is good news for health insurers. There is a new breed of document and customer communications tools that bring a new level of agility to what in the past has often been an unresponsive process. Next-generation software solutions integrate with existing legacy systems while providing advanced design and messaging capabilities to business users within a familiar desktop tool. This way, organizations can move document design and generation out of the IT department and into the hands of non-technical, line-of-business professionals. The result is more cost-effective, agile and accurate member communication, without the need to modify your legacy business application.

Are you ready to move forward? Enlist solutions and partners that provide the right mix of expertise, vision, and advanced capabilities that will allow you to leverage the full potential of new technologies for increased document agility.

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Guest contributor Kevin Craine is the author of the book Designing a Document Strategy and host of the Document Strategy Podcast. He spent 15 years managing large scale document services organizations for BlueCross BlueShield. Currently, he is the managing director of Craine Communications Group. For more information visit