CareFirst BlueCross BlueShield’s $100 million integrated claims system and supporting software implementation was completed last August on budget and within a year of rollout.
“It was one of the smoothest, quickest implementations we’ve had,” said Etta Maguire, senior director at CareFirst BCBS.
One of the most important components of success was getting senior management involved, she said. It made sense, she added, given that TriZetto’s Facets and surrounding software would impact every department within the regional Blues plan.
Weekly meetings were held to review progress and identify and resolve bottlenecks and risks. Progress reports, testing processes and internal audits provided an end-to-end understanding of the project, Maguire said. “There was complete transparency,” she said.
CEO Chet Burrell was involved and aware of each project lead to ensure that milestones and commitments to the plans were kept, Maguire said. CEO-level focus also helped validate the implementation done by internal staff and provided support and motivation throughout the process, she said.
While Maguire couldn’t put a number on how much was saved by meeting implementation milestones, she said CareFirst expects “significant savings” from Facets and the supporting software in the form of reduced administration and increased customer satisfaction.
CareFirst plans to complete an upgrade to Facets by the first quarter of 2010, said Maguire.
Although health plans should always pay more attention to how much they spend on IT, reductions in membership and revenue because of rising unemployment have made payers scrutinize their IT investments more closely, said Greg Maguire, vice president of consulting for TriZetto.
CareFirst put more emphasis on rigor and discipline with this implementation, he said. “It’s a significant expense to replace legacy infrastructure systems,” he said. “You need upfront change control and change management planning.”
Don’t expect this implementation to be the norm. “Having a claims system implementation finish on time and on budget is definitely not a trend,” said Carl Doty, vice president and research director for Forrester Research. It’s still a common complaint that projects go beyond deadlines and over budget, even in these recessionary times, he said.
What makes CareFirst unique is that its CEO came from a health IT company, Doty said. It’s in his DNA to be so involved in a health IT initiative, he said.
