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Member 360 Solution: An Integrated View of Member Information


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The Member 360 solution provides a multidimensional member-centric view into member wellness, fitness and behavior, enabling health plans to better tailor health services for members, transforming their experience through wellness and healthy living outreach programs.

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Member 360 Solution: An Integrated View of Member Information

  1. 1. IBM Sales and Distribution Health Plans Solution Brief Member 360 for healthcare Gain a panoramic view Employers and members, frustrated with the rising costs of healthcare Highlights benefits, are looking for multiple alternatives to maximize their invest- ments in benefits payments, and to reduce their costs, including shift- ● Gain a consolidated and trusted ing more costs onto the employee and personal health savings plans. enterprise-wide view of member information Employees, bearing much more of the burden for healthcare costs, are making increased demands for service, value and personalization. ● Present member-centric information to Health plans need to be able to provide improved service to both, and all member servicing touch points and channels the start of that improvement needs to be better management of mem- ber data. The Member 360 solution for healthcare from IBM can help ● Optimize member-centric data and deliver information as a service healthcare organizations deliver a highly personalized experience by providing a single, complete and consistent view of the member across ● Improve health program outcomes and all servicing touch points, while meeting tactical cost-of-care reduction effectiveness while reducing overall costs goals and strategic overall health and financial wellness goals. ● Increase knowledge-based decision A holistic view of the policyholder maximizes service and reduces costs making through deployment of modern analytics technologies through integrating information across the enterprise. By creating a single view of the truth across disparate systems, you can dramatically streamline analysis, care and product development processes. A 360-degree view of the patient helps transform care, and real-time information analysis can speed delivery of appropriate programs. This technology-driven delivery can enhance efficiency and also help healthcare organizations reduce costs—and organizations skilled at identifying and deploying key technologies have a sustainable competitive edge because they can defend their market share amidst increasing competition. The Member 360 solution can help healthcare organizations transform into more member-centric businesses, offering competitive advantage to health plans that can aggregate and draw insights from the volumes of data stored in their systems. Our solution provides a flexible archi- tecture that helps reduce the expense of data integration and provides a single, enterprise-wide view of critical business and member data. Using insights gained from an aggregate view of a customer’s health records, health plans can help customers better manage their health, reduce medical costs and increase customer satisfaction.
  2. 2. Unlike inflexible point-to-point solutions that can inhibit growth and For more information adaptability, an integrated information management approach allows To learn more about the Member 360 solution healthcare organizations to achieve several important benefits. for healthcare, please contact your IBM represen- Hospitals and physicians practices can improve the quality and safety of tative or IBM Business Partner, or visit: care, increase patient satisfaction, enhance operational efficiency and cost-effectively comply with government regulations while reducing the cost to maintain their information infrastructure. The solution can also help health plans boost growth and profits, comply with govern- ment regulations, respond to consumer pressure for more choices and accelerate claims processing while addressing employers’ objectives for health and wellness solutions. The Member 360 solution utilizes a comprehensive end-to-end transformation framework to easily and quickly deliver an integrated information management system for health plan data. The solution provides information and insights across the enterprise at strategic points 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 all systems and channels. ● Improve member satisfaction by offering, convenient self-service functionality. ● Interact and build relationships with members through online services. ● Manage the complete member view along several dimensions, includ- ing role, household and product. © Copyright IBM Corporation 2010 ● Integrate and manage all of the various enterprise member enroll- IBM Corporation ment, claims, health management and personalization data in real Route 100 Somers, NY 10589 time or in batches. ● Enable new customer-centric strategies, such as transparency and Produced in the United States of America March 2010 consumerism, and outline an enterprise information management All Rights Reserved strategy and roadmap. IBM, the IBM logo and are trademarks or ● Build provider relations by speeding the claims process and improv- registered trademarks of International Business Machines ing accuracy. Corporation in the United States, other countries, or both. If ● Gain better insight from information to understand and serve mem- these and other IBM trademarked terms are marked on their first occurrence in this information with a trademark symbol bers more effectively. (® or ™), these symbols indicate U.S. registered or common ● Provide easy access to information while helping to ensure data and law trademarks owned by IBM at the time this information systems are secure. was published. Such trademarks may also be registered or common law trademarks in other countries. A current list of ● Deliver the right information to the right people when they need it. IBM trademarks is available on the Web at “Copyright and trademark information” at Our Member 360 solution can transform your organization’s data into Other product, company or service names may be a strategic asset, making a difference in how you do business. IBM is a trademarks or service marks of others. proven leader in software development and innovation, and we con- tinue to make significant investments in the area of healthcare and Please Recycle insurance. We understand your business objectives, and design our solutions to be open, scalable and reliable. HHS03003-USEN-00