A wise insurance executive-perhaps a chief information officer-once stated: "The strategies that worked for us in the past are the same ones that will cause us to fail in the future. That's because those strategies are only competitive for awhile."Carl Ascenzo, chief information officer for Boston-based Blue Cross Blue Shield of Massachusetts, didn't deliver this proclamation, but he easily could have. Over the years, in a career spent at Aetna Health Plan and PriceWater-houseCoopers before coming to BCBSMA, Ascenzo has seen things that were seemingly built to last fall by the wayside.

For instance, he has seen companies push proprietary systems out to their constituents, believing they would provide a competitive advantage. He also watched corporations offer Web self-service capabilities to customers, believing that as long as they build it-and however they build it-they would come.

"It was always a belief that proprietary technology offered to affiliates-both hardware and software applications- would provide an organization with a competitive edge," says Ascenzo, who's been CIO at BCBSMA since 2000.

"I learned over the years that when you're dealing with constituents (such as health providers or members), offering them multiple, proprietary installations of technology is actually negative. The technology fails to remain a differentiator because versions change so quickly. Even if you have a competitive advantage, it's very short-lived."

Providing better service

When it comes to Web self-service, many companies were stuck in the belief that for initiatives to work, they had to be transaction-centric, he notes.

"From a transaction standpoint, Web self-service adoption by BCBSMA customers only reached about 10% before it stalled," Ascenzo says. "We learned there are other ways to spur adoption of self-service to members. The difference is the information you have and how you can leverage it to provide better service."

Phasing out proprietary systems to better enable business partners to electronically communicate with insurers is becoming the more pervasive strategy. So is rethinking Web self-service.

But in many cases, there's still a great deal of uncertainty about what online self-service should consist of. The health industry, in particular, has an opportunity to enable members to locate a physician, find information on drug interactions or discover effective ways to treat illnesses without seeing a physician.

In this spirit, BCBSMA--for its 2.5 million members and 15,400 HMO physicians--has rolled out a number of programs designed to provide pertinent, mission-critical information to make lives and jobs easier. It's all part of Ascenzo's value-added objective.

"We want to take member service to a world-class level, and we've developed an extensive customer relationship management system to enable us to capture more information with continuous feedback to provide better service," Ascenzo says.

"As we add more capability (to the Web site) over time, this leads to greater self-service adoption. Over the years, we have placed an emphasis on transactions. But as the health care industry evolves, our role is to influence and assist individuals through distribution of information."

Relationship builder

Over the past two years, the litany of e-business features that BCBSMA has developed for its constituents is impressive.

The Blues plan offers an Internet tool that enables members to access hospital-related information to help make more informed decisions about health care needs, in partnership with their physicians. The Select Quality Care Consumer tool provides detailed side-by-side comparisons based on each member's specific needs and preferences.

BCBSMA also developed an early identification and daily census system to improve clinical quality of care provided to members. The system identifies those members eligible for a disease management program soon after diagnosis, and alerts clinicians for early intervention. To date, nearly 5,100 patients were enrolled and 1,600 physicians were participating in the program.

Other e-commerce initiatives include:

  • Sales/account automation. The service enables brokers to generate and manage quotes and produce proposals. By reducing the complexity of the quotation generation and renewal process, productivity has increased and the cost per account under management has decreased.
  • WebMD. Through its relationship with Elmwood Park, N.J.-based WebMD, BCBSMA offers enhanced online self-service, giving providers access to member eligibility, claim status, and referral and authorization information. BCBSMA also offers online education that supports health and wellness goals of both members and providers.
  • Administration simplification. A series of online initiatives enables members and providers to conduct business more easily. WebVisit is a pilot program to reimburse physicians for qualified online consultations. Conducted with Emeryville, Calif.-based RelayHealth, this program also provides members with another way to communicate with physicians for non-urgent health situations.

Past experiences

As BCBSMA offers these programs, Ascenzo has been out front and center sponsoring and enabling them. He spent 18 years with Aetna Health Plan, taking a traditional career path from programmer to project manager on the application development side.

As a partner with PWC where he managed the technology practice for the Hartford, Conn., geographic area, Ascenzo dealt with an array of public and private industries. In this role, he oversaw strategy, products, pricing, risk management, finance, recruiting, sales and service delivery.

A business-oriented tenet that has remained with him wherever he's gone is: Success is based on relationship building.

"Relationships are based on trust, and trust is based on credibility. The PWC experience allowed me to see how other industries viewed and valued IT in relation to their business," Ascenzo says.

He took this tenet and applied it to BCBSMA where the culture between business and IT is one "where everyone is an equal partner-across the business units and IT. We are open. There is nothing that can't be shared."

Referring to it as a "push-pull" dynamic, Ascenzo approaches business teams with this premise: IT can't make a business do something it's not prepared to do.

"Our role is to push on the business areas through education and knowledge about IT and how it can drive top-line growth and bottom-line efficiency," he explains.

"When a business decides to move its capability to leverage technology, we want them to pull us quickly in that direction. It's a healthy push-pull relationship, but it's always focused on business needs. We don't do things just because we're enamored by IT."

The way Ascenzo views it, his IT stewardship at BCBSMA is centered on assuming a responsibility for wedding IT strategy to the business strategy. "We're responsible for the technology architecture for the company, but we hire the services of others to do the running of the facilities."

In the build versus buy decision-making process, Ascenzo says BCBSMA regards itself as a "buy" shop. It prefers to acquire existing components, but if the company fails to find IT solutions that fit its needs, it will build internally.

"However, we 'buy the build,' so to speak. We have no programmers as internal employees. We're totally outsourced from an operations and development standpoint. The company buys the solution but farms it out for deployment."

Ascenzo manages an IT budget that has been steady to declining over the past three years. "On the project side, we've actually increased the budget over the past four years. I'm very comfortable with the project budget fluctuating up or down as business needs dictate," he says.

"Whatever we do, no initiatives we've embarked upon have ever been done to decrease costs, but rather to add value and better service, as well as to retain existing customers and attract new ones."

Satisfying the masses

One way to satisfy the masses is through the ongoing addition of Web self-service functionality. But as the company adds functionality, Ascenzo says it's important to standardize the site. "Branding a self-service vehicle must be consistent," he says. "If we decide to change something, it changes everywhere."

The front-end work would not be as successful without real-time integration of data and what Ascenzo calls "industrial strength" systems.

Components developed around the legacy systems must provide security and auditability, as well as be able to handle high volume and perform at expected response times. An industrial-strength system also has recoverability in case of a system outage, he says.

At BCBSMA, the marketing department oversees Web presentation capabilities. Using templates developed by IT, the marketing team creates every corporate Web page-a departure from what the company had done in the past.

"Formerly, marketing never got involved in how Web screens were designed or presented. The business departments did these things on their own. Now marketing has a design and approval role," says Ascenzo.

When the marketing team establishes a Web design strategy across the enterprise, content is maintained by subject experts in the business departments. And scenzo's IT unit provides the IT infrastructure for content management.

For the next year, Ascenzo has compiled an IT spending wish list, led by the replacement of core administration systems to make them more member-centric and personalized.

The second goal is to play a leadership role in creating an IT infrastructure that will enable dynamic information-sharing within the health community. "It's part of fostering our electronic health agenda," adds Ascenzo.

The third objective is data security. "The whole area of security is moving very quickly. We must stay abreast of these things," he says.

Ascenzo believes programs that have been put in place are making inroads, reinforced by the fact BCBSMA benchmarks virtually every aspect of its performance-from service quality to cost.

Looking ahead, IT's role will only become more aligned with the goals of the business, he says. "It's very heartening to know you can go about your business, and you don't have to worry about having to sell IT against the (corporate) tide," says Ascenzo.

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