Population Health Provider Boosts Quality and Customer Satisfaction for Member Health Solutions


Overview

The company is a major population health provider and independent subsidiary of a top U.S. health insurance provider. Its suite of products caters to large health plans, delivering analytics and decision support tools to help improve the health of their members.

The company’s wellness apps, care management, condition management and other mobile/web apps serve a population of 20 million consumers. The products analyze clinical data, such as lab results and pharmacy records, from submitted claims to provide suggestions and recommendations to improve member health.

For instance, data from these different sources can be analyzed to show risk for a patient developing a particular condition, such as diabetes. The mobile apps are monitoring 64 million patients and generating a savings of $1,856 per nurse-engaged member per year, along with a 6.1 percent reduction in admissions for disease management participants.

Business Opportunity

Despite having a well-rounded suite of population health products to serve a wide variety of constituents, the company was struggling with quality management and a higher than average quantity of user complaints. It lacked standard testing and quality assurance (QA) processes, resulting in challenges achieving time-to-market goals and high costs for development.

These issues were hampering the company’s ability to compete in the market and achieve optimal patient management and cost reduction goals for clients.

Solution

emids came on board to establish a practice for integrating business analysis (BA) and QA roles that included the creation of a comprehensive testing center of excellence for the client along with other processes implementation across the development cycle. By merging the BA and QA roles, the client benefited from more comprehensive test coverage, incorporating both user stories and acceptance criteria. The BA-to-QA model placed individuals with both sets of skills on each end of the process, telling developers how to build the feature at the outset and ensuring they did it right upon completion.

We provided an initial assessment, instituted best practices, integrated BA and QA recommended tools and conducted Agile training and test automation across the company’s entire portfolio of products. The engagement has ramped up to more than 220 emids team members today, located in both offshore and onshore offices to facilitate 24-hour workflow coverage.

What started as a BA and QA engagement has now matured into a much broader initiative based on overall quality and time-to-market improvement, with services expanding to include delivery and management for product development and infrastructure support.

Results

The BA/QA integration we provided enabled the company to uncover defects early in the development process and helped identify metrics that contribute to the overall quality of the product. The establishment of testing center of excellence and institutionalization of best practices led to improved performance metrics year on year across BA and QA functions.

  • Made a successful transition to an Agile testing approach
  • Standardized QA practices across the product portfolio
  • Contained spiraling QA costs by more than $500,000
  • Achieved 60 percent time savings through test automation
  • Reduced release cycle time by 20 percent
  • Maintained zero severity 1 defects for last 3–4 releases
  • Increased automation testing by 70 percent, resulting in roughly $200,000 in annual savings

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