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IBM > Case Studies > A US-based healthcare company gets ahead of a growing claims volume
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A US-based healthcare company gets ahead of a growing claims volume

Technology Category
  • Application Infrastructure & Middleware - API Integration & Management
  • Application Infrastructure & Middleware - Data Exchange & Integration
  • Application Infrastructure & Middleware - Middleware, SDKs & Libraries
Applicable Industries
  • Healthcare & Hospitals
Applicable Functions
  • Business Operation
Use Cases
  • Process Control & Optimization
  • Predictive Maintenance
Services
  • System Integration
  • Software Design & Engineering Services
The Challenge
This US-based company provides a diverse portfolio of health and well-being services. It relies on a claims processing application to support its operations. This application was handling the organization’s existing claims volume, but changes within the healthcare marketplace, particularly around government healthcare initiatives, were expected to drive up that volume. A technology manager within the organization anticipated the growing demands on the company’s claims processing systems and took action. He created a modernization strategy for the organization’s two IBM zEnterprise® EC12 servers running IBM CICS-based application workloads to improve application performance and help accommodate the growing claims volume.
About The Customer
The customer is a US-based healthcare company that provides a diverse portfolio of health and well-being services. The company relies heavily on a claims processing application to support its operations. The application was handling the organization's existing claims volume, but changes within the healthcare marketplace, particularly around government healthcare initiatives, were expected to drive up that volume. The company anticipated the growing demands on its claims processing systems and took proactive measures to address the issue. The company's technology manager created a modernization strategy for the organization's two IBM zEnterprise® EC12 servers running IBM CICS-based application workloads to improve application performance and help accommodate the growing claims volume.
The Solution
The company engaged IBM for a workshop on System z integration architecture to identify the limitations of the company’s systems and develop a roadmap to address them. The team used IBM software, including the IBM CICS Interdependency Analyzer for z/OS® and IBM CICS Performance Analyzer for z/OS applications, to better understand the company’s environment and obtain performance metrics. The roadmap began with low-risk activities, such as recompiling COBOL programs with the latest compiler and implementing CICS Thread Safety methods, and progressed to more complex solutions. These included using IBM CICSPlex® System Manager software for greater resiliency and using the rules decision tool to promote greater flexibility and business logic reuse. The IBM team also deployed IBM Operational Decision Manager software to help automate business rules processes.
Operational Impact
  • The company improved CICS-based application performance by 10 – 20 percent and reduced the cost of processing claims, positioning it to handle growing numbers of claims.
  • The organization reduced CICS CPU usage by approximately 10 – 20 percent.
  • With Operational Decision Manager software, the company made its decision assets more reusable and empowered employees to create and update their own decision services, enhancing speed to market.
Quantitative Benefit
  • Improved CICS-based application performance by 10 – 20 percent
  • Reduced CICS CPU usage by approximately 10 – 20 percent

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