Member 360 forhealthcareGain a panoramic view

IBM Sales and Distribution Health PlansSolution Brief

Highlights● Gain a consolidated and trusted

enterprise-wide view of member information

● Present member-centric information toall member servicing touch points andchannels

● Optimize member-centric data anddeliver information as a service

● Improve health program outcomes andeffectiveness while reducing overallcosts

● Increase knowledge-based decisionmaking through deployment of modernanalytics technologies

Employers and members, frustrated with the rising costs of healthcarebenefits, are looking for multiple alternatives to maximize their invest-ments in benefits payments, and to reduce their costs, including shift-ing more costs onto the employee and personal health savings plans.Employees, bearing much more of the burden for healthcare costs, aremaking increased demands for service, value and personalization.Health plans need to be able to provide improved service to both, andthe start of that improvement needs to be better management of mem-ber data. The Member 360 solution for healthcare from IBM can helphealthcare organizations deliver a highly personalized experience byproviding a single, complete and consistent view of the member acrossall servicing touch points, while meeting tactical cost-of-care reductiongoals and strategic overall health and financial wellness goals.

A holistic view of the policyholder maximizes service and reduces coststhrough integrating information across the enterprise. By creating asingle view of the truth across disparate systems, you can dramaticallystreamline analysis, care and product development processes. A 360-degree view of the patient helps transform care, and real-timeinformation analysis can speed delivery of appropriate programs. Thistechnology-driven delivery can enhance efficiency and also help healthcare organizations reduce costs—and organizations skilled atidentifying and deploying key technologies have a sustainable competitive edge because they can defend their market share amidstincreasing competition.

The Member 360 solution can help healthcare organizations transforminto more member-centric businesses, offering competitive advantageto health plans that can aggregate and draw insights from the volumesof data stored in their systems. Our solution provides a flexible archi-tecture that helps reduce the expense of data integration and provides asingle, enterprise-wide view of critical business and member data.Using insights gained from an aggregate view of a customer’s healthrecords, health plans can help customers better manage their health,reduce medical costs and increase customer satisfaction.

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Unlike inflexible point-to-point solutions that can inhibit growth andadaptability, an integrated information management approach allowshealthcare organizations to achieve several important benefits.Hospitals and physicians practices can improve the quality and safety ofcare, increase patient satisfaction, enhance operational efficiency andcost-effectively comply with government regulations while reducingthe cost to maintain their information infrastructure. The solution canalso help health plans boost growth and profits, comply with govern-ment regulations, respond to consumer pressure for more choices andaccelerate claims processing while addressing employers’ objectives forhealth and wellness solutions.

The Member 360 solution utilizes a comprehensive end-to-end transformation framework to easily and quickly deliver an integratedinformation management system for health plan data. The solutionprovides information and insights across the enterprise at strategicpoints in the business operation. This can help improve overall opera-tions and customer satisfaction.

Our solution can help you:

● Provide current, accurate and complete member data to virtually allsystems and channels.

● Improve member satisfaction by offering, convenient self-servicefunctionality.

● Interact and build relationships with members through online services.

● Manage the complete member view along several dimensions, includ-ing role, household and product.

● Integrate and manage all of the various enterprise member enroll-ment, claims, health management and personalization data in realtime or in batches.

● Enable new customer-centric strategies, such as transparency andconsumerism, and outline an enterprise information managementstrategy and roadmap.

● Build provider relations by speeding the claims process and improv-ing accuracy.

● Gain better insight from information to understand and serve mem-bers more effectively.

● Provide easy access to information while helping to ensure data andsystems are secure.

● Deliver the right information to the right people when they need it.

Our Member 360 solution can transform your organization’s data intoa strategic asset, making a difference in how you do business. IBM is aproven leader in software development and innovation, and we con-tinue to make significant investments in the area of healthcare andinsurance. We understand your business objectives, and design oursolutions to be open, scalable and reliable.

For more informationTo learn more about the Member 360 solution for healthcare, please contact your IBM represen-tative or IBM Business Partner, or visit:ibm.com/healthcare

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