PERFORMANCE ENGINEERING FOR A HEALTHCARE PAYER PRODUCT

A disruptive healthcare IT solutions provider in the US has a product that Healthcare Payers use to improve outcomes and reduce administrative costs. The platform provides end-to-end policy administration, such as member enrollment and engagement, health plans, premium administration, claims management, and contract management with care providers. The platform offers features for both medical and dental insurance services.

The company has a clientele that includes large and mid-sized payers. It has a few state-level Blue Cross Blue Shield and Delta Dental organizations as customers and would like to increase its footprint amongst larger organizations.

THE CHALLENGE

Due to the rapid growth in customer base, the company faced complaints regarding its product’s performance, including member enrollment, provider search, and claim adjudication. They wanted to address the specific performance issues to maintain and enhance its position as a serious contender. The leadership team also wanted to scale their company’s product engineering capability to speed up releases without compromising the product’s architecture and performance.

WHY NEWSCAPE

Newscape Consulting offers niche technical and domain-focused solutions to healthcare companies. Newscape’ s testing experience helps healthcare companies define their testings trategy, make performance improvements, design the testing scenarios, automate tests, and execute test cases .

SOLUTION

The product had no standard method to analyze the performance issues present in the product. Newscape deployed three agile teams to work with the company’s engineering teams. Each team consisted of 8-9 members, including engineers, technical leads, testers, and product analysts. They worked on two areas: performance engineering and feature development.

Newscape created a performance lab ecosystem to conduct a detailed study of all modules and best practices. They implemented the AppDynamics application performance management software (APM) across the product. They monitored the CPU usage, regularity of garbage collection for each server, performance of database queries, API performance, and many other aspects to identify the bottlenecks.

Two product development teams implemented new features in the product. They resolved over 250 defects in the member enrollment module, integrated with Provider Directory, and improved the performance of primary care provider (PCP) auto-assignment. The team implemented a performance benchmarking ecosystem using industry standards.

They built many customization capabilities on top of the core product, upstream and downstream integrations, and used connector services to integrate the product with customer’s systems and facilitate information exchange. They made crucial enhancements in the dental billing functionality to improve the user experience of payments, cashless functionality, and payment disbursal to care providers. The teams also enhanced the user experience by reducing the payer UI response time during provider search.

The Newscape teams worked closely with the client’s engineering teams and project managers to execute two-week sprints with a product release every three sprints.

TOOLS & TECHNOLOGIES

N

Weblogic-based enterprise application

N

Proprietary Java-based frameworks for ORM, transaction management, caching, and database querying

N

SOAP-based services to the connector layer to integrate with external entities.

N

An OSGi-based services backbone hosted on Apache Karaf. Contains business validations and acts as a proxy to the product’s SOAP services

N

Two Oracle instances as database, one for CRUD operations and another for reporting. Java-based components replicate prominent entities to the reporting instance

N

Desktop application frontend based on Windows .NET, C#, and Windows Forms with user-configurable reporting

N

Newscape introduced AppDynamics as an Application Performance Management platform (APM)

BENEFITS

N

The end-customers achieved their goals for a successful open enrollment

N

The team increased the enrollment process throughput by over 10 times, and database performance fixes and creating new indices alone increased throughput by up to 10%.

N

The company caught potential performance issues before product releases with the new performance benchmarking ecosystem

N

Improved the productivity of enrollment specialists using several features for member health conditions and workflow wizards

N

Improved the billing workflow for orthodontia and dental claims to bring in accuracy and federal compliance.

N

End-users could prioritize their workflows and screens based on their unique needs, e.g., separating high-value claims from low-value ones and prioritizing claims pending for a long time

N

Insurers can now create custom business rules for coverage limits, branded coverage plans (e.g., Gold, Silver, Bronze), co-pay and co-insurance limits, etc.

ABOUT US

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Performance Engineering for A healthcare Payer product