The Picture of Health

Blue Cross and Blue Shield of Florida draws on SAS® reporting strengths for enhanced customer service

As the major health-insurance companies vie for lucrative contracts that keep them strong in a weak economy, they rely on innovative customer service strategies to help them stand out from the crowd.

In fact, Blue Cross and Blue Shield of Florida (BCBSF) has a group whose main purpose is to serve as consultants for the business needs of the company's group customers. Duties involve preparing annual reports in which they analyze customer medical costs and the drivers behind increases or decreases in those costs. But static annual reports are no longer sufficient to assist customers and staff in managing the benefit plan costs during the year. In between annual reports, the group fields frequent ad hoc requests from the 100 marketing representatives who work at offices around the state to serve the needs of existing clients and to attract new ones.

Ultimately, what they're doing is delivering cost-saving reports into the hands of their customers faster than ever.

"These days, customers are very sophisticated about their medical costs. They want information more often so they can track what's going on with their employees," explains Jose Sanchez, Director of the Major Accounts Consulting Group at BCBSF. "We decided to develop an online application so the reps could order reports themselves without having to go through us. That way there would be no lag time in getting the information to their accounts."

With SAS, Sanchez – along with Dawn Allen, Senior Accounts Consultant; and Jim Williams, Senior Systems Analyst in Information Management – built a data mart that generates 22 different kinds of reports based on 120 million observations, several thousand times a year. The team used SAS/IntrNet to extend data analysis and reporting capabilities to all 100 marketing reps. The intranet application shields reps from the technological complexities, providing quick and easy access to the answers their customers seek.

The SAS application enables marketing reps to build their own reports on medical costs over specific time periods, and it reflects the successful collaboration between marketing and IT. The reports include key indicators by time periods as well as medical cross-utilization indicators, encompassing details surrounding utilization reports about facilities, physicians, providers, and pharmacies. Armed with such information, clients can better control insurance costs and enhance the health of their members

At the management level, BCBSF uses the reports in efforts to attract and retain customers. The reports might explain and justify, for example, why rate increases may be appropriate. When customers understand the real reasons, they tend to stay in the fold. The ability to respond to inquiries regarding medical service utilization and costs during the plan year can also serve as a key differentiator as the customer considers alternative health plans before open enrollment begins.

"With rates going up these days, the companies we insure are working hard to reassure their own clients. They need a lot of information and they want it more rapidly," Allen says. That poses a challenge for marketing and sales reps, especially if they receive a request for information at 5:30 in the afternoon. "Having this self-serve application on our Web site now allows the reps to go online, generate the report, and have it to the account first thing the next morning," she says.

In fact, reps can usually have an answer within five minutes and e-mail the reports to their clients - a virtual revolution in customer service. "The sooner the account gets the information, the sooner we can start talking with them about it," Sanchez says. "Before, they had to call us, we'd mail it to them, and it could take a week or two before they received the information. Because of SAS, we can now provide it in an instant. SAS has revolutionized how our reps work with their accounts, and the primary reason we developed this application was to help our reps better serve our customers."

BCBSF chose SAS for its marketing application because Sanchez and his team knew it was capable of handling the workload and would be a breeze to get up and running. During the previous 20 years, Sanchez had developed reports with SAS that had become the company's gold standard for cost and utilization information. In developing its online reporting application, the group continues to use those same reports. "That was a tremendous help in both time and performance, because we knew the reports were accurate and valid," Williams says. "We saved tremendous effort by eliminating the need to rewrite them in another language or platform or with another kind of tool."

In addition to giving reps speedier access to essential reports and quicker turnaround for customer queries, the Major Accounts Consulting Group has cut IT charge-back costs by nearly 30 percent for the past three years because they now store reporting data on their own Unix box. "Before, we had to go to a different system to get that information, but now it's all in place," Sanchez says. "With the speed and turnaround time we're now offering, this project provides tremendous value by getting the right information in the right hands at the right time and place."

From a technology standpoint, Sanchez appreciates that SAS has the flexibility to customize reports with information like the top 20 diagnoses and all the related costs. "A lot of programs are basically SQL, so they summarize and print, but they don't provide the flexibility to do complex computation in programming for our reports," Sanchez says. "SAS allows us to incorporate information from different platforms and apply the analytics of SAS. Originally, we did look at several other applications, but they didn't have the flexibility in generating reports that SAS has."

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