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4th Annual Investor Conference
May 16, 2001
BUSINESS TRANSFORMATION AND INNOVATION SERVICES
Gary Velasquez
President
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Business Transformation and Innovation Services was formed to:
Expand capabilities to ensure business goals are met
Reduce operating costs
Manage operating/technology risks
Ensure disciplined use of capital for technology projects
3
EAI
Network
KBASE
Call Center Applications
IRMA
ExternalInternal
JD Edwards
Macess Imagine
MC400
FARE
QCare
Filenet Macess
ABS
Call Center Applications
EnterprisePortal
Packaged
Applications
Provider Connectivity
New
Existing Environment
CSC MH Power
Infrastructure a year ago was complex adding non-value added costs
4
BTIS Short-term Goals
Reduce operating costs
Extend PPO Infrastructure to meet current production goals
Develop and implement product enhancements to drive top-line growth
Create a common technology architecture
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BTIS Long-term Goals
Continue to reduce operating costs
Install common technology architecture
Expand capability to support broader product portfolio
Develop solutions that support seamless interaction among consumer, provider, employer and health plans
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Network
External
Internal
Call Center Applications
EAI
Customer InterfaceProvider Connectivity
Digital Transaction Engine
DataWarehouse
Consumer
Self Service
Consumer
Analytics
Product
Configurator
Sales Force
Automation
Medical
Management
Health Net is moving to enterprise standards
...building in flexibility & speed to market
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To meet goals, focus on the five core competencies...
Product Development
Customer Services
Distribution
Care Management
Administrative Services
which drives annual SG&A expenditures of $1.4Bor 14% of Revenue
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Targeted savings will reduce SG&A expenditures by 100 bps
Fully Operational Annual SG&A Savings Targets
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Total 100 bps
5
0
Current SpendClaims
Enrollment& Billing
TargetSpend
Information Technology
CustomerService
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MedicalMgmt
20
20
1500
25
Other
“Reductions are not driven by revenue volume”
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Project Portfolio
Health Net Competencies
DistributionProduct
DevelopmentCustomer
ServiceCare
ManagementAdministration
Services
- Siebel Latino Care MedicalManagement
System
Online enrollment& billing
- Sales Portal PPO EMSO
Claims processing
Questium
MedUnite
NaviMedix
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Partner for Solutions, not Build
Partners bring:
Proven, market-tested solutions and services
Highly technical and skilled labor force
R&D environment
Leverage non-Health Net capital base
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Small scale, live environment test (10-20K lives) Pilot
Demonstrate the flexibility and capability of the systemPrototype
Fully test the model office hypotheses in a non-live environment on real business
Create tailored implementation plan
Solution Lab
Maximum benefits will be realized from engineering business processes. Most efficient/effective processes with companion metrics will be developed
Model Office
Specific Outcomes for each phase Phase
Deployment Deploy to the full book of business
5-phased Approach to Deployment
Execution requires a disciplined approach
…to achieve results and mitigate risks
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Moderated Panel
Product Development and Customer Service
Distribution
Care Management
Administrative Services
Steve Sell
Kathleen Richard
Jonathan Scheff, MD
Paul Gilbertson
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Product Development/Customer Service Competencies
Steve Sell
Questium
Business Transformation and Innovation Services
Health Net, Inc.
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Consumer Timetable - May 15, 2000
Consumer Website Development Well Along
Functions Include: Registration, Changes, History, E-mail, Reminders, Actionable Content
Introduce for Health Net California for 2000 Open Enrollment
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Questium Health and Wellness
Challenges/Opportunity: Continue to lead in health plan customer service
Health Net Response: Create a range of online self-service model with web-enabled content/information, service delivery andtransactions
Partnerships: Pharmacy Benefits Manager Development
Expected Outcome: Increased retention and new sales SG&A reductions over three years Pave the road for defined contribution
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Questium Personal and Professional Life
Challenges/Opportunity: Broaden and redefine EAP product Leverage the MHN client base and the
consolidation of employer benefits
Health Net Response: Create an online self-service product, with web-enabled assessments, self-help interventions, self-referrals and “Ask-the-Expert”
Partnerships: Work/Life Services Assessments and interventions
Expected Outcome: Existing client upsale opportunities Increased new sales
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Distribution Competency
Kathleen Richard
Senior Vice President
Business Transformation and Innovation Services
Health Net, Inc.
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Sales Automation System
Challenges/Opportunities: • Streamlined, effective processes and tools to drive new sales and retention
Target Market: • Health Net California Mid Market
Capabilities: • Contact/communication management• Lead/prospect management• Reporting• 150+ Users
Partner: • Seibel Systems
Expected Outcomes: • 8% Increased Sales Force Capacity• 8% Improved Close Rate• 8% Improved Sales to Existing Customers• 8% Improved Retention• Full Benefits Realized in 2003
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Sales Web Portal
Challenges/Opportunities: • Provide customers with access to online quotes • Automate and streamline current processes
Target Market: • Health Net California Individual and Small Group
Capabilities: • Online Quoting • Interactive Product Comparisons • Proposal Generation • Collateral Ordering/Downloads • Full Broker Sales Functionality • “Smart” Applications & e-Signature
Expected Outcomes: • 15-25% Improved Sales Force Productivity • 95% “Clean” Application; 30% With No
Underwriting • Improved Account Management, Lead Management and Broker Service
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Care Management Competency
Jonathan Scheff, MD
Chief Medical Officer
Health Net Federal Services
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Medical Management Capability
Competencies: Care Management in TRICARE
Challenges: Changing business rules Parallel Delivery Systems Manual workflows
Health Net Response: Channels patients to Military Treatment Facilities Case Management/Disease Management Health Care Analysis Population Health
Technology Solutions: Internet based Medical Management System Scalable from Federal Services to Health Net Enterprise
Partnerships: In process
Expected Outcome: Automate business process Standardize business functionality Improve ability to coordinate care
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Administrative Services Competencies
Paul Gilbertson
Senior Vice President
Business Transformation and Innovation Services
Health Net, Inc.
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Enrollment and Billing
Competencies: Administrative Services
Challenges: Highly manual processes with multiple systems Impacts multiple functions and business processes
Health Net Response: Eliminate fragmentation within value chain Create standardized solutions Introduce and push self-service capabilities
Technology Solutions: Internet based applications with “smart” user interfaces
Partnerships: TRICARE Commercial
Expected Outcome: 50% TRICARE member adoption by 2003 At least 10% commercial member adoption by 2003
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Provider Initiative - May 15, 2000
Single Website for Provider Interaction with Plans
Focus on Eligibility, Claims Referral and Formulary Compliance First
Claims Adjudication and Payment Further Out
Easy to Use, Single Site with Links to Plans and Other Services
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Provider Connectivity
Competencies: Administrative Services
Challenges: Highly manual processes with multiple systems Impacts multiple functions and business processes
Health Net Response: Eliminate fragmentation within value chain Create standardized solutions Introduce and push self-service at the physician office desk
top
Partnerships: MedUnite NaviMedix
Expected Outcome: 40K physician users by 2003 25 to 35 million transactions by 2003
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Business Transformation and Innovation Services was formed to:
Utilize partnerships that have technical capability and financial resources
Develop an enterprise technical architecture which leverages existing investments
Implement a portfolio of business/technology linked initiatives that drive results across business units
Continue use of existing capital approval process; ensure all major initiatives are driven through “Solution Lab” methodology
Expand capabilities to ensure business goals are met
Reduce operating costs
Manage operating/technology risks
Ensure disciplined use of capital for technology projects
Goals Actions
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Demonstration Booths
Questium - Personal and Professional Life
Questium - Health and Wellness
Online Enrollment & Billing
MedUnite
Enterprise Portal
Questium - Personal and Professional Life
Questium - Health and Wellness
Online Enrollment & Billing
MedUnite
Enterprise Portal