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Health Care Case Study

Case #3948: IT Strategy Development and Program Management - Legacy System Replacement

A large mid-Atlantic Health Insurance and Managed Care organization was looking to enhance its core legacy systems in order to meet new business objectives and significantly enhance customer service. The company's legacy systems were built to support traditional health insurance products. Although they had been modified over the years to include some of the managed care functionality, the costs, time and difficulty of continuing to evolve those systems had become overwhelming.

This company launched a project to replace and/or re-engineer its core systems. The project consisted of a team of IT and business professionals that were chartered with designing and building IT solutions for the future member-centric healthcare market.

We were engaged to partner with the company in support of building the blueprint for future systems, selecting key packages, and developing detailed plans for the migration effort. Multiple initiatives were defined as a result of these efforts. Some of these initiatives included:

  • Program Management
  • Package Assessment
  • Enterprise Application Integration (EAI)
  • Reengineering Broker Commissions
  • Reengineering Premium Billing
  • Legacy Restructuring
  • Enterprise Modeling
  • Project Infrastructure

Engagement Highlights

  • Industry:
  • Health Insurance & Managed Care
  • Client:
  • A mid-Atlantic Insurance and Managed Care Company
  • Assignment:
  • Develop a long-term IT strategy for modernizing core technology platforms
  • Migrate business from legacy systems to the new platform
  • Re-engineer and streamline business processes
  • Transform group-centric business into a member-centric business
  • Approach:
  • Development of a detailed roadmap for systems modernization
  • Senior-level Tier team, consisting of architects and designers
  • Integrate existing systems with new technology through EAI
  • Enable a plug & play systems platform by replacing hard-coded interfaces with generic connectors
  • Duration:
  • 52 weeks

Results

  • Developed detailed plans and roadmaps for implementation
  • Revised current systems architecture
  • Implemented EAI architecture approach

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