Wednesday Jan 27, 2016

Watch LOMA Webcast on Demand: A Progressive Approach to Insurance Policy Administration Transformation

Many carriers are embarking on a transformation journey to modernize their core policy administration systems in an effort to provide more flexibility, improve speed-to-market and increase revenue growth and profitability. However, there is simply nothing as daunting as a full policy administration system replacement project. These initiatives take multiple years to complete, and they are expensive and risky. There are many significant and high-profile policy administration system replacement programs that have ended in failure.

To reduce risk, some carriers are using progressive migration instead of full system replacement. These carriers implement some components of the system first – such as new business, commission or billing – then expand to full policy administration functionality once the technology is proven. This approach allows carriers to achieve incremental returns on the investment and minimize risk. It reduces the need for carriers to take a “big bang” approach to modernizing and gives the flexibility to implement the additional capabilities of the full policy administration system later, without having to rewrite all the rules, products and calculations.

In this webcast, Oracle and LOMA invite you to learn more about this approach and explore how insurers can use Policy Administration components to achieve enterprise agility while reducing risk.

For more information on Oracle Insurance Policy Administration, visit oracle.com/insurance.


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Wednesday Jan 20, 2016

Continue the Transformation and Modernization Conversation during Oracle Industry Connect 2016

The impact of digital disruption is being felt across the insurance industry. For many insurers the answer lies in a progressive transformation for both the customer engagement process and the underlying systems with customer-centric processes and industrial-strength core components.

At last year’s Oracle Industry Connect, Kimberly Harris-Ferrante, Vice President and Distinguished Analyst at Gartner Research, led a panel discussion on the trends, challenges and opportunities facing insurers today. She was joined by Francine Hampleman from La Capitale and Deborah Norton from Harvard Pilgrim Health Care, who shared their recent transformation experiences.

At Oracle Industry Connect 2016, we will continue the conversation on process modernization as it affects life, annuity, P&C, and health insurers. You will not want to miss an opportunity to network with your industry peers and participate in discussions about the impact that digital disruption is having in the Insurance industry. The program will include sessions and panel discussions where industry experts and Oracle customers will review technology requirements to support product innovation and discuss how newer technologies such as Data as a Service (DaaS) can drive significant value for insurers in the future.

We look forward to seeing you in Orlando, FL.

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Wednesday Jan 06, 2016

Webcast: Navigating the Continuum of Health Care Reform: The Role of Bundled Payments

The emergence of value-based contracting models represents an evolution in clinical and payment methodologies aimed at creating better quality and cost outcomes, greater provider accountability, and improving cost efficiency. As the Centers for Medicare & Medicaid Services (CMS) rolls out Bundled Payment pilots – for the reimbursement of healthcare providers on the basis of expected costs for clinically-defined episodes of care – health insurers are wrestling with the reality of making these arrangements work in their current environments.

In this webinar, we will examine the advantages and disadvantages of the Bundled Payments reimbursement model as well as the consideration for entering into these contracts with your providers. The discussion will also touch on how current systems have limitations on whether these programs are administered prospectively or retrospectively.

Attendees will also learn how modern component-based technology solutions, specifically designed for emerging value based payment models, can help healthcare payers make this process easier and more efficient. We’ll explore how you can move from spreadsheets to automation in this informative seminar.

For more information on Oracle Health Insurance Components, please visit oracle.com/insurance.

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Monday Dec 07, 2015

Modernize Your Quote-to-Application Process

Many insurers are looking for solutions that can drive revenue while managing long term goals for growth.  One of the ways to drive revenue is to equip your sales team and partners with tools to help them sell more insurance products. Insurers can make their teams more efficient by making products more transparent (so that it is easier to do comparisons) as well as providing the best pricing for their customers’ needs.

Unfortunately, many of the systems that support the sales process have not kept up with technology advancements. Manual process and old technology make it harder for insurers to help their sales people and partners configure the right product and coverages. There are multiple systems throughout the sales process, and sometimes people must rely on spreadsheets, paper forms, and email. So there is no a single sales tool that can help sales people increase their productivity.

Let’s take an example of the selling process in the Large Group line of business. What makes selling Large Group products such a challenge is that there are many factors that sales people need to consider when they configure a plan such as product dependencies, compliance issues and other factors that add to the complexity. As you can imagine, when sales people are trying to manage hundreds of products, and hundreds of different coverage combinations, we can see that there are some real pain points around configuration. This is especially clear if you're managing your product, pricing, bundling rules manually or using excel spreadsheets.

If you want to drive more revenue and align your sales process with the way customers are now buying and become a more forward-thinking insurer, you ought to see this short video. The solution that we propose is generic enough that any line of business (life, health and P&C) for both personal and commercial can use.

For more information on Oracle Insurance, please visit oracle.com/insurance.

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Tuesday Dec 01, 2015

Reduce Medical Loss Ratio by Straight-Through-Processing

With the steady increase of healthcare costs, health insurance payers are challenged to find new ways to reduce cost. As a payer, you have three ways to achieve this: reduce reimbursement, reduce coverage or reduce the cost of running your business. The first two options shift the cost towards providers and members and are not viable in a competitive marketplace, making the third option – reducing the medical loss ratio – an attractive choice.

Kathy McCarthy, Director of Sales Consulting for Oracle Health Insurance, discusses the topic in today's post.

Any payer strives towards a claims administration where straight-through-processing is the norm. Yet, not many payers get to boast auto-adjudication rates higher than 95%. In fact, many payers do not even come close. And given the volume of claims in health insurance, even if you achieve an auto-adjudication rate as high as 95%, that still means you have to deal with (tens of) thousands of claims that can’t be processed without some kind of intervention.

Obstacles to getting here include:

  • Inherent Complexity
  • Collaboration, Mergers and Legacy Systems
  • Evolving Benefit Plans

One alternative is to make sure that your back office is flexible and agile enough to follow the business wherever it may go. After all, isn’t the purpose of enterprise software to make business easier? There are three aspects to straight-through-processing in a componentized architecture:

  • Integration
  • Coordination
  • Auto Adjudication

The combination of these traits is the primary design principle of Oracle Health Insurance Components. They offer pre-integrated applications for the health insurance market that are configurable through fit-for-purpose, parameter-driven rules – giving you the agility you need to keep up with the constant influx of new market requirements – that can be extended with your own settings and logic to meet your specific business requirements – giving you the flexibility you require to achieve operational excellence.

  • Download the new white paper in English
  • Download the new white paper in Spanish

For more information on Oracle Health Insurance Components, please visit oracle.com/insurance.

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About

Oracle’s solutions provide the modern, rules-driven flexibility insurers need to support Digital Insurance transformation, simplify their IT environments, and innovate to keep pace with changing demands.

For more information, visit oracle.com/insurance.

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