Agis Insurance uses Mendix to deploy critical Health Procurement Portal
With over one million clients and 1,500 employees, Agis is one of the largest specialized healthcare insurance companies in the Netherlands. An enterprising and driven insurer, Agis takes pride in the service it provides its customers. Equally important to Agis is the relationship it has with its healthcare providers, who in turn ensure that Agis’ clients always have access to quality healthcare tailored to their needs.
Notably, Agis also provides coverage under the Dutch Exceptional Medical Expenses Act (AWBZ) to eligible recipients in the Netherlands. This collective health insurance policy, administered by the government, pays for hard-to-insure treatments and services, such as nursing homes and residential care for disabled people.
Changing procurement regulations increase administrative work and costs
It is Agis’s involvement in providing this AWBZ coverage that is the subject of this case study.
In 2006, the Dutch government decided to transfer parts of its AWBZ mental healthcare program to the private insurance sector, thus creating a new healthcare system with regulated competition. To comply with the new rules, insurance companies, such as Agis, are obliged to contract healthcare providers for these hard-to-insure treatments and services. In every region, one insurer is granted a concession by the government to deliver in-kind insurance. The insurance company bears only administrative costs associated with this delivery and is completely compensated for healthcare costs.
However, strict government and European Union (EU) regulations apply to the healthcare procurement process. This includes an annual tendering procedure, in which healthcare providers in a specific region submit a bid to the regional insurer to provide the required healthcare services the following year.
In the case of Agis, this was an extensive and expensive process involving bids from some 300 healthcare providers. Every bid needed to be scanned manually for key data, which then had to be evaluated before the successful tenders were selected. This meant dealing with an enormous amount of paperwork, which kept 20 Agis employees busy for three months. “This front-office data also had to be re-entered manually into Agis’ back-office healthcare-procurement application,” says Björn van der Poel, enterprise architect at Agis. All this made the healthcare procurement process slow, error-prone and expensive.
This is representative of an evolving healthcare insurance industry and ever-changing healthcare legislation, both of which force Agis to continually reengineer its internal processes, “which unfortunately also has a significant impact on the IT landscape and is very costly”, says Cor de Koning, who heads Processes and Automation at Agis.
Agis seeks an automated solution and a fast implementation
Agis was looking for a fast and cost-effective way to procure AWBZ-related healthcare and to process and manage the resulting information. At the same time, the solution needed to offer healthcare suppliers and customers an improved service, and fully comply with Dutch and EU regulations, including a critical deadline.
Agis decided that the answer was to automate all AWBZ-related activities, both for its own personnel and its healthcare providers’. Importantly, this solution would have to lower Agis’ administrative costs, and increase satisfaction among its customers and healthcare providers through better service and more transparency. In addition, the solution would have to be user-friendly and scalable, as well as flexible enough to quickly deal with new demands in an evolving healthcare market with continually changing regulations. A key requirement, Agis needed to automate the procurement process within eights weeks, due to a deadline imposed by the authorities.
“What we needed was a cost-effective application implementation platform that offered fast design, development and installation, as well as scalability, continuity, and the ability to cope with a large number of changes,” says De Koning.
Agis finds the answer in the Mendix solution
Following an extensive selection process, Agis decided to go with the Mendix platform. A multidisciplined development and implementation team comprised of Agis business consultants (from its AWBZ business unit) and enterprise architects worked closely with Mendix business engineers to create models and customize templates to Agis’ specific workflow business rules and data requirements.
Serving both Agis and its healthcare providers, the AWBZ application allows both types of users to streamline, manage, monitor and control their AWBZ activities—involving a collective budget of €2.5 billion—as well as exchange such information as tender details, healthcare costs, and payments (advance and final).
Healthcare providers have access to their own Self-Service Portal designed in the same recognizable Agis corporate look & feel, and Agis procurement managers and back-office personnel are provided with a separate Workflow Portal. This portal also offers Agis procurement managers an efficient way of evaluating and selecting tenders (based on price, capacity and quality), as well as monitoring and managing operational costs and payments.
Transactional data is also exported to Agis’ external back-office healthcare-procurement application. In addition, Agis customers have web based access to details of Agis’ current healthcare providers, as required by Dutch law.
Building and implementing a business application cost- effectively and quickly
“The Mendix platform enabled us to automate our business processes in a way that is flexible and future-proof—which fully complies with our way of thinking,” says De Koning.
This flexibility was underscored by a fast development turnaround. “Development on the Mendix platform was at least five times faster than using conventional methods and tools,” says Van der Poel. “This is because Mendix allows developers and business users to interactively create visual models to define the process flow, application logic, screen layouts and data model, from which it then instantly generates a custom-built internet application.”
This means results could be immediately validated, and models easily adjusted to reflect the frequent regulatory changes Agis received during development. The close involvement of business users in the development process ensured the final deliverable matched user requirements 100 percent.
Mendix also offers developers the facility to interface with external applications (such as Agis’ back-office healthcare-procurement application), which can breathe new life into legacy systems. Exposing critical systems to the web requires advanced security measures. Mendix includes an extensive and proven security model that stands the test of our customers’ highest security requirements.
On the performance of the Mendix Business Server, “We have not encountered any real-time performance problems with the Self- Service Portal handling some 300 intensive concurrent users,” says Van der Poel.
“And recognition from the Dutch Consumer Association for having the ‘Best Healthcare Procurement Process in the Netherlands for 2007/2008’ further confirms we are on the right track,” concludes De Koning.
