Healthcare First Look at fixing health plan member services.
Now that more members have visited leading plans' Web sites, HMO executives are looking for a return on their service investments. But the ROI bar is moving higher as plans make more investments across their service channels. In 2003 alone, a third of plans will apply a portion of their IT budgets to upgrade their online self-service apps, while a similar number will invest in enhancements to software for agent-assisted customer service. As one plan leader told us, "We implemented a system for our reps with a member-specific screen pop based on IVR input that saves 5 to 20 seconds per call right off the bat. Saving 40 to 50 seconds per call overall really adds up when you have call volume as high as ours."

Health plans' multichannel services call for new incentives and SLAs. To cut costs, senior management should reward service managers for innovative cross-channel connections like offering a bonus for creating a script and a CSR incentive plan that successfully directs high-volume, low-value call center users to the appropriate Web tool. To smooth connections with their service partners at the PBMs, plans should negotiate tighter service-level agreements (SLAs), and require their subcontractors to adopt data and technology standards -- such as Web services and computer-telephony integration (CTI) tools -- that streamline member handoffs between their respective service systems.

What does Organic IT mean to health plans? After years of paying for dedicated servers, hard disks, and leased network capacity to support each new standalone application, bold IT execs are re-engineering infrastructure resources as commodities that can be drawn when needed like water from the faucet. This centralized control over commodity infrastructure assets promises to cut costs in half -- but not overnight. A health plan's voyage toward flexible deployment begins with cataloging existing assets, setting clear IT standards, and picking an Organic IT partner among HP, IBM, or Sun. It's time for plans in the midst of building new consumer-directed product offerings to lay an Organic IT foundation. Need to know more? Contact Eric Brown at ebrown@forrester.com.

ePrescribing: after the hype. Handling prescriptions electronically is complicated business. Last year, Forrester predicted the rise of ePrescribing system builders that would bring all the pieces together from point-of-prescribing apps to transactional networks to MD and consumer decision support. RxHub and SureScripts, dueling would-be system-builders for all ePrescribing in 2002, tout modest and divergent directions today. But brace for a surprise: To deny RxHub its high-information differentiation, SureScripts will edge closer to its rival's model.

We are very interested in your feedback on our research. Do you have topics to recommend, data you need, or technologies you want assessed? Drop me a line with your input at bradholmes@forrester.com.


Brad Holmes
Healthcare Research Director

Research Referenced In This Issue If you printed this email, get links to the research featured in this week's issue by going to www.forrester.com/go and entering the five-digit number of the report you'd like to read. ePrescribing: RxHub And SureScripts After The Hype (16785) How To Fix Health Plan Member Service: Part One (15453) How To Fix Health Plan Member Service: Part Three (16429) How To Fix Health Plan Member Service: Part Two (16428) What Organic IT Means To Health Plans (16823)

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