Data at work: Maricopa County uses dedicated, online employer services from CIGNA HealthCare to streamline management of 16 health plans for employees

Health Management Technology, Jan, 2005 by Robin Blair

Picture this: You're the benefits manager of an organization that offers 16 health plans to more than 15,000 employees. That's one health plan for nearly every 1,000 employees. It's your job to steer the benefits ship--to ensure appropriate plan designs, coverage levels, cost containment measurements, customer service for employees, innovative programs geared to tackling high-utilization targets, and data reporting and analysis for the organization where the cost of health benefits alone is $90 million. Can you imagine undertaking that job without a heaping helping of information technology?

Maricopa County, Ariz., Benefits Manager Pat Vancil couldn't--and didn't. Vancil came to Maricopa County government from UnitedHealthcare, where she managed customer service and where "I had all kinds of technology at my fingertips. I was accustomed to having eligibility information, claims data and pharmacy data available whenever I needed it." She brought with her to Maricopa County a keen understanding of information technology as a tool to get a challenging job done faster and better.

Maricopa County covers more than 9,000 square miles and includes about 3.2 million inhabitants. It's the 14th largest county in the U.S. and the fourth most populous county in the country. More than half of the state's population lives in Maricopa County, which includes the cities of Phoenix, Tempe, Mesa and Scottsdale.

County employees are fortunate to have a choice from among high-option or low-option PPOs, HMOs, POS (point of service) plans and a self-funded medical plan with high and low options, along with two different pharmacy plans, also offering high and low options. But multiple choices for employees require administrative savvy and finesse behind the scenes, where waiting a month for data and paper reports from the health plan is a formula for failure.

Fortunately for Vancil, that formula is just a fantasy. She and her team are everyday users of CIGNAaccess.com from CIGNA HealthCare. In the healthcare landscape, health plans have stepped up to the IT and self-service plate like nobody's business, better and faster than any other entities. CIGNA HealthCare, well-known for its broad member/ employee portal myCIGNA.com, added CIGNAaccess.com to the portal interface in 2003 as a dedicated, online benefits management tool for more than 2,700 benefits plan managers who are CIGNA customers.

Problem-solving Capability

Vancil says that when she needs data, she needs it instantly and in real time to service two primary audiences: County employees looking for help and fellow County administrators looking for cost-efficiencies and improvement opportunities.

"County employees still come through our doors looking for help, or they may come through the County's benefit coordinators. Either way, we can immediately go online, determine whether their enrollment information was accepted and is correct, see if they are in the right plan and instruct them on how to use the employee portal more efficiently," says Vancil.

She has a staff of 17 employees who work for her, and about 10 of them use CIGNAaccess.com as an efficiency tool for benefits-related problem-solving and issue resolution. Vancil says she can immediately and electronically enroll a member in a health plan option, so that if a provider calls about that member as a patient, the benefit coordinator can view real-time, newly created membership data.

Beyond answering members' questions, Vancil and her team use data from CIGNAaccess.com to steer the benefits ship. "We get eligibility reports and utilization reports. I can view claims data, line item by line item, if necessary. We can slice and dice available data in multiple ways, to aid in analysis, trending and the design of future health initiatives."

Functionality by Design

CIGNA Director of Internet Communications and Services Sandra Clifford says none of this happened by accident. Clifford herself was involved for three years in the development of multiple components that evolved into CIGNAaccess.com. "When we started, we worked with employer focus groups to determine what they needed. In all the focus groups, we saw a clear delineation between applications that employers wanted to help them work with their employees and the need for separate applications for benefits managers that would focus on reporting, costs, utilization and opportunities for savings."

For CIGNA, that meant developing the composite product so that one portion provides benefit managers with interactive tools to assist employees, and the other portion provides private management tools for internal planning and analysis. Interactive tools include:

* an online enrollment and eligibility maintenance application with which a benefits manager can add new employees and make changes to the benefits selection or demographic data for existing employees;

* the ability to look up benefit information for plan members and dependents, and to see that and claims information much the same way that members do on myCIGNA.com;