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Multi-State Nonprofit Health Insurer

Advancing Personalized Engagement With Health Benefits – Anytime, Anywhere

What if... we could create a modern, consumer-centric digital experience for a leading health insurer?

Our client, a nonprofit insurance provider, offers health care coverage in the employer, individual, Medicaid, and Medicare markets. Its networks serve members across an eight-state service area, including innovative accountable care organization (ACO) partnerships with leading provider systems.

Two people looking at information on a tablet together.

Creating a Highly Connected Digital Experience

Today’s healthcare consumers expect the same quality of digital engagement from their care teams that they experience in their everyday interactions with retailers.

Our client struggled with siloed data and outdated, fragmented experiences across its B2B and B2C digital front door properties, including its website, mobile app, and consumer portal. The sites were costly to service and severely lacked the features and capabilities that users demand. Consumer satisfaction and retention suffered as a result.

The organization also needed a technology platform that could adapt and scale as the payer expands into new markets.

We were asked to bring a holistic, innovative approach to modernize the insurer’s digital experiences, leveraging our strategic understanding of the healthcare industry and its consumers.

Abstract waveform of data points


Enabling Progress and Personalization With a Scalable Technology and Data Backbone

Exceptional digital experiences require well-integrated platforms that can securely channel data and provide a smooth consumer journey. Our client needed to break down the silos that kept it from achieving this goal.

We looked cross-functionally and holistically and built a solution that strengthened the organization’s position as a reliable partner to its administrators and its members. To achieve this, we built a data environment that equips the enterprise with the insights it needs.


Building a Roadmap and Strategy for Change

To begin, we needed to identify the technologies that would help the payer realize its strategic goal of an improved customer experience (CX). We began by conducting an in-depth assessment of the company’s current state, its desired future state, and its organizational structure, and then used those findings to develop a case for change.

Our proprietary technology platform assessment identified the ideal platforms to support the organization’s transformation. Those recommendations included Sitecore for its website, MuleSoft for APIs, Microsoft Azure DevOps for shared teams to conduct and manage their work, and Microsoft Azure Cosmos DB as a read-optimized data store.

Abstract waveform plane of data points.


An Agile Development Approach

In order to conduct development activity in an Agile manner, we needed to migrate all business and development teams to Azure DevOps. This would enable management of the digital transformation program and allow collaboration across the different development and business teams. The rollout included program requirements definition and subsequent configuration, implementation, training, communication, and launch.

The new DevOps orchestration hub equips teams with greater visibility into progress and provides tools to automate builds and process tracking.


Driving Real-Time Personalization With a Transformative Data Infrastructure

To fuel personalized experiences, our client needed to gather and display data from multiple sources in as near-real-time as possible.

We implemented MuleSoft and developed more than 30 APIs to power the compliant exchange of member, people, claim, and provider data. The content located across these systems lacked a consistent identifier (or, in some cases, used PHI as the identifier), so it was vital that we build a canonical model and encryptions that would safely stitch the data parts together for greater usability.

Change data capture processes accelerate data transfer from multiple sources and enable real-time streaming ingestion. Various data layers and Microsoft Azure tools work behind the scenes to ingest and optimize the information for downstream application consumption. Additionally, we provided configuration and implementation guidance on a member portal.

Data that previously required up to four hours of processing time can now be surfaced in seconds – a process with multiple moving parts, and a challenge that demanded a partner like Perficient with broad and deep expertise.

The lakehouse pattern also reduces operating costs and provides version history with “time travel” visibility into patient records, enabling users to better understand decisions around claims.

With data consolidated from numerous systems, the API can drive personalized experiences across the payer’s member-facing mobile and web channels.

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experience design

Design Thinking Drives Impactful Digital Experiences

We equipped our client with a solution tailored to what plan administrators need from their partners as well as what members need from their insurers and from their care experiences.

Using a design thinking framework, we integrated and blended our development processes and experience design across the client’s website, mobile app, and customer portal, enabling teams to nimbly accelerate development and rollout.

experience design

Delivering Better Care Across Channels

We leveraged this integrated approach to UX enhancement to accelerate the design and launch of a new website on the Sitecore platform.

Our design, accessibility, and healthcare experts led rebranding initiatives, designed user experiences, and established an information architecture to support user journeys.

We framed a strategy and execution plan to expedite efforts across workstreams and meet tight timelines with multiple collaborating partners. Our team spearheaded the transformation, starting with the website and Individual and Family Benefit Plans’ shopping experience. We rapidly generated more than 300 pages and created more than 100 design comps and 230 copy documents for the new site.

Colleagues strategizing together.

experience design

Defining What's Now, New and Next in Mobile App Experiences

Our client had questions about if and how to approach the mobile channel. Leveraging our Now/New/Next approach, we presented the mobile experience through the lens of various consumer experience journeys – account management, care and access, benefits, claims, prescriptions, wellness, and engagement.

For each of the seven journeys, we defined table stakes considerations – such as search engine optimization and accessibility – that must be included in order to gain parity with industry standards.

Next, we identified emerging experiences, such as personalized health actions and multi-language support. Finally, we identified innovative solutions that could truly differentiate the insurer’s mobile app experience from its competitors.

This process identified the baseline mobile considerations that must be addressed before pursuing emerging and innovative features, helping the organization envision the app’s future and prioritize its rollout.

change management

Ensuring Program Health Through a Holistic Operating Model

Our client recognized the impact these transformations would have on teams that manage the digital properties and supporting data. Change management was a vital step to ensure success and return on the organization’s investments.

We led exercises with key stakeholders to better understand existing workflows and individual responsibilities. We then shaped an operating model tailored to the ways the payer does business, but with enhanced processes that would boost efficiencies while also supporting the experience and technology. The operating model and training we delivered included guidance on process measurements and governance checkpoints, equipping the team to quantify progress and uphold quality standards.

The new operating model fostered team buy-in while changing and enhancing the way this industry leader runs its digital operations.

Our digital transformation solution provides the insurer’s B2B and B2C consumers with quick, personalized access to accurate information, equipping members and plan administrators with the tools they need to support better health in the communities they serve. 


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Boosting Outcomes for the Business and Consumers

The organization has rallied around the benefits of a better front-end consumer experience, with its teams now enabled to efficiently and effectively leverage new technology and deliver better service to plan administrators and members.

Our digital transformation solution provided multiple benefits to the payer’s teams and members:

  • Equipped the enterprise with scalable technology platforms to remain competitive now and in the future
  • Boosted efficiency by equipping users with self-service tools, decision support, and digital communications
  • Improved care quality and reimbursements by delivering a fast, responsive digital experience, anytime and anywhere
  • Elevated speed to market with extensible, flexible omnichannel solutions
  • Enhanced satisfaction and boosted recruitment and retention by providing modern, intuitive experiences that reduce friction from the healthcare consumer journey

Our digital transformation solution provides the insurer’s B2B and B2C consumers with quick, personalized access to accurate information, equipping members and plan administrators with the tools they need to support better health in the communities they serve.

Backed by an end-to-end portfolio of capabilities and solutions and our deep healthcare expertise, we were able to quickly address the organization’s challenges and goals. This nimbleness, combined with our platform development and user experience design excellence, made us the ideal partner to help the organization with this critical initiative.

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