Coventry Health Care provides managed care products to 1.7 million members in 13 markets. A leader in managed care’s second tier, the company competes mainly against regional rivals, and competition is fierce. Looking to add value to its products and reduce operating costs, Coventry turned to USinternetworking to remake its Web presence, adding compelling new functionality.

Solution Overview

Industry

Health CareMicrosoft Software Used

Microsoft® Commerce Server 2000

Microsoft Windows® 2000 Advanced Server

Microsoft SQL Server™ 2000

Microsoft Visual Studio® Developer Tools

Third-Party Software

Arcana Scheduler

SoftArtisans FileUp

Radware WSD Pro

The company’s most immediate needs were twofold: to implement a transactional and content management system with a Web-based front end that worked with its legacy systems, and to consolidate multiple Web sites into one site with multiple front doors. These had to be customized for various visitors: members, employers, brokers, and providers. Content owners in each market had to be able to manage their portion of the site. Visitors had to be able to complete transactions that previously required a call to Coventry’s call center for customer service assistance.

“At the time, we had limited Web experience,” explains Harry Fox, Coventry’s vice president of e-commerce. “But we wanted to deploy very quickly, we didn’t want to go out and hire an army of people, and we didn’t have much experience with the complexities of making legacy systems work with the Web in this way.”


Why Commerce Server?

Coventry Health Care charged USinternetworking with a complex mission: to devise and implement a transactional and content management system with aWeb-based front end that would consolidate the Internet presence of its 13 business units, communicate with its legacy systems, reduce its customer service costs, and be ready for market quickly. The staff at USi responded by building aunique solution that is centered on Microsoft® Commerce Server 2000 but extends the product beyond the traditional definition of commerce—namely, selling. Instead, USi customized Commerce Server to provide services and content in an innovative way.

USi’s expertise deploying complex solutions in an enterprise space and its ability to design, develop, implement, and support the solution for a fixed monthly rate made it the right match for Coventry. USi started by locking down the business requirements and scope of the project, andthen divided it into three phases.

In phase 1, USi replaced Coventry’s corporate Web site and disparate market-specific sites with one cohesive, content-rich, function-rich site that has doorways into market-based specifics. The site launched in fall 2000.

In phase 2, deployed in February 2001, USi gave Coventry members transactional access to their personal data, such as their mailing address and claim information. In phase 3, employers will get similar transactional access to their roster of employees and the invoice for their account. This functionality is scheduled tolaunch in the fall 2001.

Upon hearing Coventry’s requirements, USi’s team thought immediately of Microsoft Commerce Server 2000 to manage the type of transactions the company wanted to offer. The choice was made for three reasons: scalability, availability, and reliability. Says Andrew Burton, USi ebusiness product manager, “We became very confident about providing a scalable solution with Commerce Server 2000 that was highly available and highly reliable.”

Better for Members—and for the Bottom Line

In addition to providing visitors with information about Coventry’s health plans in various markets, the solution allows members to perform four functions that used to require a personal interaction with someone at Coventry’s call center:

  • Completing status transactions, such as inquiring about the status of a claim or a member’s eligibility
  • Changing member information, such as the member’s address or primary care physician
  • Requesting information, such as a new ID card or brochure
  • Notifying the health plan of changes, such as the birth of a child or the start of secondary insurance coverage

Whereas members could search provider directories before, now they can search drug formularies and pharmacy directories, too. They can even access a PDF of their unique ID card and print it instantly if they lose their original.

“Before these sites went live,” says Fox, “there were really two ways to get something that you needed to know from us: You could ask your employer or you could call us during the day. This solution extended us from a 9-to-5 shop to a 24/7 operation.”

Not only are members likely to rejoice, but the change is good for Coventry’s bottom line, too. The driving force behind this project was to decrease operational costs.

After costs for medical care, the expense of providing customer service eatsaway at the company’s operating budget faster than anything else. Most customer service calls, even low-level transactions such as changing a member’s address, average two to three minutes, explains Fox. While such a transaction cancost as much as U.S.$5.00 if the member calls up, it costs Coventry only $0.35 for the member to complete the same transaction online.

Technological Components

The solution developed by USi uses a two-tier architecture, with a Web and application tier on the front end running the Microsoft Windows® 2000 Advanced Server operating system and a data tier onthe back end running Microsoft SQL Server™ 2000.

There are three functional segments to the solution: a virtual or production Web farm, an analytics aspect, and a content management piece. In the Web farm, multiple Web servers are load balanced for traffic fluctuations. Behind this is the data that drives the site through Commerce Server 2000.

To provide analytics, a data warehouse sits outside the Web farm and allows Coventry to mine its site data and generate reports to evaluate what visitors are doing. As for content management, USi built a customized content interface sothat owners in each of Coventry’s markets can be responsible for the content that pertains to their customers.

Respective database servers power each segment. A dedicated, secure T1 connection between USi and the Coventry legacy system allows real-time Extensible Markup Language (XML) calls rather than batch processing.

Three of the features of Commerce Server 2000 that are critical to Coventry’s solution are the Profile System, the Business Desk, and the Business Analytics System.

With the Profile System, Coventry can deliver unique customer-focused content and services for each of its user groups: members, employers, brokers, and providers. According to Burton, it provides the foundation for having one central site that delivers customized content keyed to the regional requirements and other specifics of Coventry’s many different health plans. The Profile System also allows for member registration and authentication so users get personalized access to their individual information.

The Business Desk provides centralized Web-based management—in Coventry’s case, for its geographically disparate site administrators and content creators. So designees at each of Coventry’s plans can manage their plan’sportion of the Web site through acentral, secure, extensible interface. The Business Desk is also an important element in how the solution meets Coventry’s business needs while also containing costs; no client-side configurations are required for the company’s remote users.

Coventry uses the Business Analytics System to mine data about its users’ activities. The system is a dynamic, interactive reporting system, says Burton, that provides decision support through analytics that go beyond click-stream data to include integrated user analysis, trend analysis, and site analysis that Coventry can use to improve its site information and services.

For instance, Coventry can mine data about use of the corporate services on its site or the services in its individual channels, such as use of plan information, health information, prescription information, or news and community information in its member channel.

Pulling Ahead of the Competition

The flexibility of Commerce Server is the aspect of this solution that most sticks with Burton. “One of the initial concerns we ran into,” he says, “was that the product is called Commerce Server 2000. The name implies that you’re selling a good or a service on the Web. What we quickly found was that, while it is a commerce platform, it is readily available to customize and it’s flexible enough to build onto provide an e-service or ebusiness solution.

“Coventry’s requirements fell outside your standard Commerce Server solution because they aren’t really selling anything online today,” Burton explains. “But Coventry represents a great example of what the product can do in an enterprise space for someone who needs to provide service to customers.

“As we’ve looked ahead to future phases and plans to expand the site, we haven’t been hampered by the product,” he says. “We’re able to integrate new components, new features, and new functionality as the client requests them. It’s the flexibility of the product that allows us to do that. We can offer all these value-added services, but the product itself is enabling us to do so in a high-quality manner.”

Coventry appreciates the way its unique solution sets the company apart. “It’s very hard today,” says Fox, “to differentiate yourself among your competitors.” Health care coverage purchasers—employers—are looking primarily at price, he explains. So any strategy that adds value is critical. “Anything you can do to get members to say ‘I’m going to lose something if I leave Coventry’ is worthwhile, even if a competitor may be less expensive,” Fox says.

“This solution has really helped Coventry leapfrog over our competitors ina number of markets,” adds Fox. His sales force calls the new sites and functionality a tremendous advantage over the competition.

“We are definitely ahead of the pack,” Fox says, “and this project is one ofthe things that put us there.”