ESI Achieves Compliant, Timely and Effective Member Communications

Challenge

Campaign management and member correspondence was time-consuming, labor-intensive and prone to compliance risk.

Solution

Indellient enables ESI to deliver accurate and timely member material that is reviewed and approved, with full compliance and the ability to prove it.

Outcome

ESI is now able to move nimbly, responding to regulations and policy changes, while growing their member base more effectively – year over year.

Preparing member and marketing materials, such as ANOCs, EOCs, SBCs, EOBs, Campaign Management and member correspondence are time-consuming, labor-intensive and prone to compliance risk. Health plans and pharmacy benefit managers face increasingly strict regulations to deliver more accurate and timely information. There is a strong need to stay ahead of demands to ensure the accurate and efficient development of marketing materials in a time-sensitive and highly regulated landscape.

ESI Ensures Customer Communications Compliance

Express Scripts Inc. (ESI), the United States’ largest Pharmacy Benefit Manager, employs 28,000 employees and manages over 80 million members. As part of ESI’s mandate, they produce thousands of member communications for dozens of employers, health plans, unions and government agencies across the country. In 2012, ESI acquired Pharmacy Benefit Manager, Medco.

The Challenge

After successfully acquiring Medco, not only did ESI’s portfolio grow significantly, it came with a corresponding increase in the volume of member communications to be produced. Of the thousands of member materials produced every year, each material type is regulated by its own set of compliance regulations, business rules, marketing requirements and more.

In short, the lack of operational insight was leading ESI to spend as much time and resources managing the administrative logistics of member communications as they were creating the communications themselves.

Needing to manage hundreds of review cycles across several teams, the company’s main challenges were:

ESI gained full visibility of the material lifecycle and can pinpoint exactly what changes need to be made and which documents have been approved with real-time status.

01

Inefficient, Manual Processes

02

Lack of Visibility and Control

03

Labor-Intensive Management

04

Overwhelmed Staff

05

Compliance Risk

The Solution

Indellient created the Blue Relay platform for one purpose; to give organizations with complex business processes, like ESI, the confidence they need to ensure that every piece of member material has been properly reviewed, approved and produced on-time, with full accuracy and the ability to prove it.

Blue Relay was up and running in 30 days and fully deployed across several teams in 90 days. Whether it was an executive that needed insight into the performance of the entire program, the team leaders who needed to resource balance all the tasks at hand or an individual team member that simply needed to know what to do next, Blue Relay had ESI covered.

01

Tracks all file related changes and activities

02

Identifies contributors and tracks changes to the document

03

Effectively handles document changes across teams and stakeholders

04

Maintains a full audit trail of document changes

Results

Since the initial implementation, Blue Relay has expanded to over 300 users across the merged organization that now use the solution as part of their daily routine. As a result, ESI is now organized to move nimbly, allowing them to handle changes to regulations, policies and member sizes more effectively – year over year. Some of the key drivers of this adoption include:

Improved Processes
Within a few weeks, manual tasks were automated which allowed the team to refocus resources on more critical activities.

Significant Savings
Approximately $5-6 million in savings over four years based on reduction in time needed to complete all necessary tasks.

Business Insight
Access to data and analytics provided operational insight to help improve performance of the entire operation over time.

Project Management
Gained full visibility of the material lifecycle and can pinpoint exactly what changes need to be made and which documents have been approved with real-time status.

Visibility and SLA Adherence
Early identification of bottlenecks and risks enabling teams to take corrective action before it was too late.

Resource Management
Leaders were able to use the insight from Blue Relay to properly load balance tasks across their team members leading to a more efficient operation with a lean team, less employee stress, and a significant reduction in employee overtime hours required to accomplish tasks.

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