MODELS UNVEILED FOR NATIONWIDE HEALTH NETWORKPrototypes for a standards-based nationwide health information network (NHIN) were scheduled for presentation at a conference last month in Washington, according to the U.S. Department of Health and Human Services (HHS).
Insurance companies are stakeholders in the NHIN, which will allow patients to manage their own health care records, move the records when they change jobs and share the records with insurers when they buy a policy.
America's Health Insurance Plans (AHIP) and the Blue Cross and Blue Shield Association have agreed to support a common set of standards for the network, according to published reports.
The January conference was the third on NHIN. The first NHIN forum, held in June, included presentations by care delivery organizations, network services and records repositories. The second, which took place in October included discussion of architecture security and confidentiality.
HISPANIC HEALTH SUBJECT OF BCC SITE
To promote health in the Latino community, Blue Cross of California (BCC) has started a Web site called NuestroBien, which is Spanish for "our well being."
The site, located at www.nuestrobien.com, presents articles in English and Spanish on prevention, nutrition and early detection of health problems.
The site's "Kids Center" provides games and animated clips on how the human body works. More than 600 health-related articles for parents, teens and kids are available in both languages.
"NuestroBien is an important outreach by our organization to the Latino community, which has been historically underserved," says Charlene Maher, BCC vice president and general manager, individual services.
Latinos account for more than half of the 6.3 million Californians who lack health insurance, even though they constitute only 31% of the state's population, says Maher. They are three times more likely than other Californians to lack health insurance, she adds.
Mary Scanlon, senior vice president of eBusiness consumer technology for WellPoint Inc., BCC's parent company, says Spanish-speaking consumers can use the information to make decisions.
"Our goal is to offer consumers new online tools that make it easy, convenient and familiar for them to get the information they need to make the best choices possible about their health and health care options," says Scanlon.
Nuestrobien.com is part of BCC's outreach to California's uninsured and underserved, the company says. "NuestroBien will prove an important key in our ongoing mission to provide affordable healthcare coverage to Californians," says Maher.
Products created to achieve that goal include Tonik, which is health insurance marketed to younger consumers who have been disinclined to buy policies. It is offered by BC Life & Health Insurance Co.
Another product, BeneFits, is aimed at small businesses that have been unable to offer coverage to employees.
TIME TO REVIEW ETHICS: LAW FIRM
The Lawson Firm, a Cleveland-based law firm that provides legal and compliance management services to the insurance industry, urges companies to review their codes of ethics in light of new annual and quarterly statement interrogatories adopted by the National Association of Insurance Commissioners, Kansas City, Mo.
The interrogatories will require companies to state whether senior officers are subject to a code of ethics, which includes the following standards:
* Honest and ethical conduct, including the ethical handling of actual or apparent conflicts of interest between personal and professional relationships;
* Full, fair, accurate, timely and understandable disclosure in the reports required to be filed by the company;
* Compliance with all applicable laws and regulations;
* Internal reporting of code of ethics violations; and
* Accountability for adherence to the code.
The new interrogatories will also require companies to state whether their codes of ethics for senior managers have been amended and whether any provision of the code has been waived for any officer during the reporting period.
AON NAMES DAIL TO GLOBAL IT ROLE
Chicago-based brokerage Aon Corp. reports that Baljit "Bal" Dail is its new global chief information officer. Dail will have direct responsibility for all information technology functions across the organization.
In his new role, Dail will still serve as executive vice president and global chief administrative officer for Aon Consulting, reporting to Andrew Appel, CEO of Aon Consulting Worldwide.
LOMA and LIMRA IN MERGER TALKS
The heads of LIMRA International and LOMA are discussing a possible merger of the two insurance and financial industry research and service organizations.
LOMA, an Atlanta life insurance association, offers research and educational programs to help members improve operational performance.
LIMRA, which serves the information needs of companies involved in marketing annuity, disability, health, life, mutual fund, and retirement savings products, is based in Windsor, Conn.
TULSA LEADS LIST OF HAIL-PRONE AMERICAN CITIES
According to predictions from CDS Business Mapping LLC, a Boston-based online hazard mapping technology company, Tulsa, Okla., leads the list of the Top 10 hail-prone metro areas.
This list is based on the RiskMeter Online's Hail Model, which predicts the severity of hailstorms for any location in the Continental United States.
In 2005, there were more than 13,000 hailstorms in the United States. Amarillo, Texas; Oklahoma City; Wichita, Kan.; Arlington, Texas; Denver; Colorado Springs, Shreveport, La., and Kansas City complete the "top ten" list.
BPMS SAID TO CUT COST AND BOOST COMPLIANCE
Business process management suites (BPMS) show promise for insurance applications, but to date the applications have been limited, according to Boston-based Forrester Research Inc.
Most BPMS have been for noncore processes, pilots or for applications that have little to do with business process management (BPM), note Marc Cecere and Craig LeClair, authors of "Reality, Opportunity, and Best Practices for Business Process Management in Insurance."
However, BPM is ideal for reducing costs, increasing compliance, and introducing new products by building processes that overcome organizational and technical barriers, say the authors, who recommend that process experts evangelize BPM while choosing simple yet visible initial applications. Enterprise architects and IT professionals need to provide the supporting data and technology underpinnings while ensuring applications use the appropriate standards.
Finally, vendors need to provide best practices in building and deploying BPM apps, identify good and bad choices for insurance processes, and develop business cases to help insurers sell BPM internally.
CASUAL APPROACH CAN PUT E-MAIL IN JEOPARDY
Most organizations make heavy use of e-mail - it is the central means by which most business decisions are documented-yet most organizations continue to have a very casual attitude toward its management, according to research from Silver Spring, Md.-based AIIM - The Enterprise Content Management Association.
According to the report, "E-mail Management: An Oxymoron?" when it comes to implementing e-mail management solutions, most end users prefer to link these solutions to their broader records and information management solution. They see enterprise content management (ECM) suppliers as the preferred source of these solutions.
"This casual approach poses significant risks to organizations," says AIIM president John Mancini.
"There are major costs associated with simply providing the storage (hardware, software, and people) necessary to managing increasing volumes of unmanaged e-mail."
Also in the report:
* More than one in three end users (35%) report that they have "not yet begun" to address such core e-mail management issues as archiving, life cycle management, retention, and disposition.
* Another 41% indicate that they have begun to address e-mail management, but "much remains to be done."
* 51.9% of small organizations indicate that they have yet to begin vs. less than half as many (25.1%) at large organizations with more than 10,000 employees.
* Only 44% of those surveyed indicate that they have a policy or strategy toward e-mail retention in their organization.
CENTRALIZED CLAIMS STREAMLINE FLOW, BOOST EFFICIENCY
The AIG Companies of New York-based American International Group Inc. formed "c-Claim" (centralized-Customer Link And Information Management) to process financial lines claims more quickly and efficiently.
"c-Claim" is designed to provide a single point of entry for all financial lines claims, including directors and officers, errors and omissions, financial institutions and fidelity. The streamlined workflow will promptly direct each new notice or claim to the most appropriate claim professional, facilitating client contact and efficient resolution. "c-Claim" staff is committed to taking ownership of all inquiries and will stay actively involved through their resolution.
"The formation of c-Claim is part of our ongoing commitment to optimize the claim handling process and provide the highest standard of service to our clients" said Michael Smith, President, Financial Lines Claims, AIG Domestic Claims Inc. "This initiative will simplify and expedite claims reporting for our brokers and insureds and improve our ability to promptly acknowledge and service their claims."
USERS PLEASED AS CLAIMS FILES GO ELECTRONIC
Experts at a recent conference in the UK praised the Lloyd's of London's vision for claims management and said the time was right to move at a fast pace, according to Lloyd's of London.
The Electronic Claims File (ECF) -an electronic filing cabinet designed to make processing claims faster and more efficient-is now available to market firms. Once adopted, Lloyd's predicts it will significantly reduce the amount of paper carried around the London market.
Rolf Tolle, Lloyd's Franchise Performance Director, outlined Lloyd's vision for claims, saying that much had been achieved but there was still a long way to go.
Another panel member, Miles Banks, director of claims at broker Aon Ltd., agreed with Tolle, and called for the market to drive adoption of the ECF.
"We are very encouraged by the comments from Lloyd's Chief Executive Richard Ward in which he says he wants to see ECF used across the market," says Banks. "The time has come for the market to move at the pace of the fastest. We cannot afford to wait for the slowest. We need to drive reform and enable those who are not moving at the same pace to join when they are ready."
Banks also says that if the market were asked to devise a paper-based system, it would have few supporters.
"A paper-based system has many hiding places for the inefficient," he stresses. "ECF will drive performance data and transparency and as such there will be no hiding place for those who are inefficient."
STATE OF SOA GOVERNANCE
Organizations across a number of industries, including insurance, are either exploring SOA or have already deployed SOA, according to a new survey. The study was conducted by ebizQ, a New Rochelle, N.Y.-based online publisher of information on business integration for business and IT professionals, vendors and analysts across several industries. With all of the attention SOA is getting, just how is it governed? With financial support from Bedford, Mass.-based Progress Software Corp., EbizQ asked 313 respondents from 21 industries, including insurance, to answer that question, as well has a number of other SOA governance-related questions.
Responses contributed to the report, "The Current State of SOA Governance," which said that while 85% of organizations have, or will soon have, a corporate governance mandate, few have formalized governance roles and 70% are enforcing governance manually. In general, respondents are not confident that their current governance approach is sufficient. In fact, 40% of the population stated their governance approach is insufficient, 17% stated their approach is sufficient and 43% aren't sure.
The report highlights that when looking at the results relative to industries, report authors were surprised to see no automation in the insurance industry. The insurers participating in the survey rely on manual audit and reporting and design reviews. The report concludes this is because 26 of 27 insurers fell into the lower ranges (0-10, 10-50) of Web services in terms of production.
