Managed Care


Improving Processes Easier Said Than Done

MANAGED CARE September 2005. © MediMedia USA
News and Commentary

Improving Processes Easier Said Than Done

MANAGED CARE September 2005. ©MediMedia USA

Nearly all health plans intend to increase business process automation in the next two years, primarily to decrease errors while increasing productivity, according to a study by First Consulting Group.

The survey of 65 health insurers includes national as well as regional plans ranging in membership from as few as 1,000 to over 3 million. Respondents were primarily CIOs, COOs, and CEOs.

Health plan officials say that they see the most manual inefficiency in product development, sales and marketing, and commissions. That is a shift, the authors say, from the three areas that showed the most manual inefficiency — claims and encounters, customer service and membership, and enrollment.

"Surprisingly claims, customer service, and enrollment are viewed by health plans as having the least amount of unnecessary manual inefficiency, suggesting that health plans must already have targeted those functions with strategies to increase efficiency," the authors note.


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