December 28, 2007 - MEGA International announced that Excellus Blue Cross Blue Shield (BCBS), the largest nonprofit health plan in New York, is using the MEGA Modeling Suite to eliminate redundant business processes and IT systems and improve information access.

 

When several Blue Cross Blue Shield programs in upstate New York merged to create Excellus BCBS, each organization brought its own business processes and IT system to the new entity. Because they were so different, yet had to be consolidated, Excellus BCBS wanted to first implement a strong business analysis process to clearly identify company functions and processes.

 

Excellus BCBS evaluated providers against certain criteria, and found that the MEGA Modeling Suite had the most comprehensive offering. MEGA International provides enterprise architecture (EA), business process analysis (BPA), and governance, risk, and compliance (GRC) solutions that are used by corporations and government agencies. The tools help them understand assets, control operations, and govern risks.

 

The MEGA Modeling Suite has helped Excellus BCBS identify all company functions and processes, as it worked to reduce duplicate processes that were a normal result of the merger. With multiple platforms and environments, it was extremely challenging to create smoothly running, cohesive business processes, without a clear understanding of what processes and systems were serving each organization. Many of these legacy systems, some in place for 30+ years, didn’t have adequate documentation, so there were parts of the systems that were completely unknown.

 

The health plan wanted to develop single systems for claims processing, provider contracting, member registration, and more, and standardize practices so that customers and others outside the organization would feel like they were dealing with a single company, rather than multiple entities in a loose federation. In addition, Excellus BCBS recognized that a key factor to their success would be a services-oriented architecture (SOA) approach, offering the ability to devise flexible architectures that rely on smaller parts (services), rather than larger holistic solutions. Being able to implement the architecture in parts gives them more choices (buy vs. build) and allows for variation in particular components to adapt to shifting market demand for products.

 

“With the MEGA Modeling Suite, we have gained a clear understanding of our processes and we have put the information in one place so that we can maintain consistency, starting at the architectural or planning level,” explained Eric Stephens, enterprise architect, Enterprise Architecture and Integration Team at Excellus BCBS.

 

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