Easing The Pain Of Managing Health Care Plans
For years, Paranjpe, senior vice president of Strategic Development at the National Business Health Coalition (NBHC), and her staff, had to do just that in order to score the quality and performance of health care providers. Then they would make recommendations to their more than 90 member coalitions, which act as health plan consultants for some 8,000 employers across the country.
For the past five years, the Washington, D.C.-based non-profit NBHC has annually sent some 50 to 75 health providers an extensive Microsoft Word-based survey known as eValue8, then scored the data and made detailed analyses based upon the responses.
"We got to the point where they would respond electronically and we'd have to reenter it in Excel. It was very time consuming, and very inefficient," says Paranjpe, in Detroit. "We pick on health plans for not being efficient and we're always griping they should leverage technology, but we have to put our money where our mouths are, too. If there's better way to do it and it means saving money, we should do it."
Enter IE-Engine, of Waltham, Mass., a three-year-old company that created a Web-based RFP repository to capture and manage the processes and costs associated with health care data.
The company focuses on purchasers of health care because "the pain had gotten so great in terms of the cost of health care," not to mention the information that needed to be compiled, according to IE-Engine Founder Brent Bannerman, who says the cost went up 10% in 2001 and 13% in 2002, and is projected to double by 2007.
Manage the Vendors
"We alleviate the situation by enabling the HR department...a repeatable process so that no matter what they purchase, they can go through the same process and protocols to make the best buying decisions," Bannerman says. "They can manage their vendors throughout the year and analyze the cost of those vendors through the same process."
IE-Engine, which will deliver v6.0 of its Human Resource Cost Management (HRCM) platform on Monday, has attracted the likes of such companies as General Motors, Ford Motor Co., Dow Chemical, Staples, Lucent and Owens Corning.
In the case of the NBHC, after meeting with other vendors that do Web-based surveys and reverse auctions, the coalition went live with IE-Engine's software in February 2002. Paranjpe says the company created a repository that allows NBHC to apply to it a set of algorithm scoring rules.
"We have layers of scoring rules, not just points, so it's very complex," she says. "If you really want to look at a health care company's performance it's not just yes/no [answers]. They built for us a scoring tool that lets us apply these rules and differentiate health plans' performance very easily."
The data resides both at IE-Engine and with the NBHC's member coalitions and employers, who receive a CD-ROM every May that lets them data mine the information. Paranjpe says the data is so vast, it would be too unwieldy and slow to capture it over the Web. The coalitions and companies, like Ford, can then independently use IE Engine to take bids over the Web to select their health plans.
In the works is giving health plans the ability to access the previous year's responses so they can update information rather than have to start from scratch, says Paranjpe.
So far, she says they have seen significant savings in man hours: about three to three and a half days per health plan. The software has also allowed them to build more sophisticated scoring rules that will enable NBHC to better understand how the health plans are performing. It can also give more detailed feedback to the plans than in the past. The feedback helps the carriers to better understand where they failed to meet purchaser expectations -- and gives the plans the opportunity to rise to the challenge, she says.
"It's taken this cottage industry...to truly a state-of-the-art reporting process," says Paranjpe. "Part of our job is to push health care providers to not just perform at the level they're at today, but to move forward."
The automated survey, she says, is motivating them. "Health care is complex and it defies logic sometimes. [The providers] know what their customers want and they want a good score because then employers will buy from them. So they want to do the things in the survey to get a better score."