Guiding a Health Insurance Agency to Architect Sustainable Growth

The Challenge

Given changing regulatory and market forces, the health insurance industry is in a state of transition. As a result, Health Markets, a former health insurance agency, shifted its business strategy by becoming a health insurance broker. The goal: to ease the complexity of, and bring clarity to, the process of enrolling in a health insurance plan. With a focus on navigating customers through evolving state and federal changes, and achieving a sustainable growth rate, the organization needs to be able to guide customers to the best coverage options for their families and their businesses.

As a health insurance agency, the organization implemented several home-grown business applications for data management solutions to enable agents and customers to view coverage options and submit insurance applications. However, with the transformation of the business model, this now-new broker firm had not yet implemented standard processes around how to effectively manage data to gain clear insight in to the new business focus. To drive home a customer-centric culture, the client needed:

  • Clarity and uniformity around key performance indicators (KPI)
  • Improved visibility with a 360-degree view of customers to better support them through their health insurance purchasing journey
  • Innovation and improved efficiencies for sustainable business practices

The goal: to ease the complexity of, and bring clarity to, the process of enrolling in a health insurance plan. With a focus on navigating customers through evolving state and federal changes, and achieving a sustainable growth rate, the organization needs to be able to guide customers to the best coverage options for their families and their businesses.

Our Approach

Sendero has a successful working history with the company’s Chief Information Officer, who had engaged us on several projects at a previous client. Our team partnered with the CIO on this new challenge, to develop an analytics strategy and roadmap to address priority needs. Collaboration with the client throughout the 10-week engagement ensured practical solutions tailored for its unique culture and environment.

Assessment: Our team conducted interviews with company executives, analysts, and developers to gather knowledge and insight into the current state of analytics. We then developed an assessment of the company’s current state to establish a baseline view of the maturity of analytics capabilites across the organization.The team’s methodology focused on five critical pillars of analytics capabilities:

  • Focus (strategy and metrics)
  • Data
  • People
  • Process
  • Technology

Strategic Vision: To effectively design an analytics strategy to help the company meet its strategic goals, our team partnered with each stakeholder to define how analytics could best enable their business and support their operations. Examples of decisions made included:

  • Defining whether to use a centralized, decentralized, or hybrid approach to governance
  • Investigating analytic styles to be supported
  • Ensuring the IT strategy is aligned with the overall strategic vision

Roadmap: With the vision established and articulated, we developed a tailored roadmap to define how the company could achieve their goals. Our team collaborated with the client to ensure multiple factors were considered, including budget, resources, priorities, and integration with business partners.

Our team partnered with the CIO on this new challenge, to develop an analytics strategy and roadmap to address priority needs. Collaboration with the client throughout the 10-week engagement ensured practical solutions tailored for its unique culture and environment.

Our Results

By providing a holistic assessment of the company’s historical use of data, the needs of individual stakeholders, and strategic objectives of the client, the analytics roadmap introduced a two-year approach, prioritizing detailed initiatives,  customized for specific needs. Our solutions:

  • Identified areas of improvement across all five analytics pillars, driving toward a culture where business decisions are based on data
  • Increased awareness of areas in which analytics needs to be actively considered, including data governance and demand management
  • Established value of having a purposeful analytics strategy to make the most informed business decision
  • An actionable, attainable, and customized plan for the company to achieve its analytics goals

We provided the company with a clear and detailed plan to effectively and efficiently move it into its new brokerage focus, for long-term sustainability and growth.

I would recommend Sendero to any company looking to optimize use of their data and analytics. Sendero was collaborative and knowledgeable throughout the project, resulting in a tailored and achievable analytics strategy and plan.

Scott Terrell, CIO HealthMarkets, Inc.

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