CIGNA Company Essay
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CIGNA is a major health insurance company. Its CIGNA Behavioral Health covers 16 million Americans in all 50 states and internationally. In addition, it supports a network of more than 50,000 professionals who needed a system that quickly and automatically approved requests submitted by providers, such as therapists, for additional patient care. CIGNA Behavioral Health’s business processes for making approval determinations were supported in different locations using several different software applications.
Certain rules in use sometimes conflicted with each other, and knowledge was lost due to employee turnover.
In addition, the rules were in inflexible if-then statements. Accessing and changing the rules was a slow, cumbersome, and expensive process. To reduce the knowledge loss due to employee turnover and to increase consistency and efficiency of rule maintenance, CIGNA Behavioral Health decided to adopt rule-based intelligent systems that could automate decision-making situations. CIGNA chose Haley Authority knowledge management (KM) software and Haley Rules intelligent system to build a Web-based benefit management system named Provider eCare Online.
How does it relate to this week’s course concepts?
According to the book, this week we learn about long-term objectives and strategies, we also learn business strategies. It talks about generic strategies and grand strategies. Include in the grand strategies there is an innovation. Innovation is making some changes to increasing markets, this issue is like this. They build this system one reason is to reduce the cost and knowledge loss, the other reason is that it can give them more markets to sell their insurance, it is also convenience for people to use this. At which conclusions do you arrive at from your analysis?
According to the book, some firms find it profitable to make innovation their grand strategy. They seek to reap the initially high profits associated with customer acceptance of a new or greatly improved product. For this insurance company, it build a system in order to solve problems and get more money, it can reach my analysis.
What are the main takeaways from the situation, your analysis, and your conclusions? In my opinions, by expressing business processes in English using Haley Rules, eCare specialists can implement changes to the rules whenever needed, in hours instead of weeks. The adoption of knowledge-based systems has helped CIGNA enhance operational efficiency and reduce costs. The tools of Haley Authority and Haley Rules in combination provide a convenient platform for the implementation of such intelligent systems. So it is really good system for them to get more money, it also can help people a lot.
John A. Pearce, Richard B. Robinson, strategy management, thirteenth edition. Cigna, cigna.com.