Greater efficiency and a happier and healthier community

Leading the drive towards an increasingly quality-minded and customer-centric operation, a top health insurance provider serving over 4 million customers sought to transform its business operations with customer commitment in mind.

At the time when it engaged KPMG, the company had a standing pledge to cap annual net income at 2 percent of revenue, and over $450 million contributed to its charitable foundation since 2002.  For these reasons, they were looking to the cloud for a single, unified system to enhance its community focus. Moreover, it needed a speedy, low-hassle solution: key elements of the system had to be fully up and running within a year to meet a critical business deadline.

With a new cloud solution in place, this insurer can lower its administrative burden and build greater value for its millions of customers. By combining multiple applications with finance and human resources operations in one system, it can improve service delivery and provide greater transparency and compliance through robust, automated reporting and analytics. Empowered by the cloud, it can make better business decisions for the physical and financial health of its customers.

The process focused on validating existing systems using KPMG’s Powered Enterprise solution rather than designing new ones. Pilot studies and testing events allowed key staff members to provide their input prior to the short construction phase, cutting down the time needed for implementation. 

Invested in affordable healthcare through a 2 percent profitability pledge, this insurer returned more than $560 million to its customers between 2011 and 2018. Affordability and community care underpin its business—including its back office. Proactively transitioning its systems to cloud could help provide better value for its customers in a changing market.

KPMG worked side-by-side with the company to develop a new Target Operating Model (TOM) that looked at every aspect of the insurer's finance functions in the context of the healthcare insurance market. This included detailed assessments of the current state of back-office operations and the desired future state. The outcome was an ambitious yet achievable road map. 

This company knew that having access to robust, streamlined data and analytics as well as efficient and effective operations and processes could help create greater affordability for customers. Moving from an external data center to Oracle ERP Cloud offered an excellent way to manage finances and champion its 2 percent profitability pledge. To keep the process quick and thorough, KPMG used prebuilt, established systems and minimized customization.

With delivery on the initial and most time-sensitive phase assured, the company is looking ahead to the transformation of other operations, including Human Capital Management and Procurement. The remainder of the system can now be smoothly implemented in a phased approach over several years, with various services and product modules configured and turned on in sequence. Allowing the flexibility to adjust for future business needs, the system also allows the insurer to better meet the needs of its customers. 

Start with targets, not technology

Technology alone does not deliver—the way it is implemented is critical to success. Approaching financial accounting system change as part of an in-depth strategic approach to corporate support functions leads to true transformation.

Collaboration for clarity and speed

When embarking on a mission-driven move to cloud, it helps to provide input throughout the build. A rapid, straightforward and collaborative process of reviewing and testing allows for adjustments early in the project while keeping customer promises in mind.