By George Linkletter

Aetna, one of the nation's largest provider of health benefits, is a prime example of how companies -- both large and small -- can achieve a meaningful competitive advantage when they innovate quickly and use technology strategically.

A case in point is the giant insurer's new Electronic Statement Presentment (ESP) capability, which went 'live' last year and is in the process of being rolled out to the firm's more than 19 million health insurance members in the U.S and abroad.

"We were intrigued by the potential of this new electronic messaging capability from the moment we first learned about it," says Dave Capasso, Business Systems Manager, Print and Fulfillment for Aetna. "And the more we learned, the more determined we became to be a leader in our industry to bring its benefits to our members."

A Focus on Customer Service
Capasso says Aetna was drawn to ESP initially by a desire to provide superior customer service through exploring ways to pilot the technology.

But as Aetna managers learned more about ESP, and especially how it could benefit Aetna as well as its millions of members, the firm shifted quickly from a limited pilot to a full implementation that would be available to everyone and would help set Aetna apart from the competition.

The internal benefits of ESP are significant, according to Capasso, a 20-year veteran with Aetna, because they encompass both the potential to boost performance by speeding delivery of Explanation of Benefit (EOB) statements and streamlining work processes.

Significant Speed = Service
Speed of delivery is critical because of the 'intangible' nature of insurance.

Making the EOB statements available electronically dramatically lessens the time required to deliver the EOBs from days -- especially in the case of mailings to members abroad -- to the mere seconds required by postings on the Web.

"Our statements are a critical contact point and link with our members," says Capasso, "and in many cases they are the only 'concrete' representation of claim activity.

Posting EOBs to the Web helps meet the need for better customer service since Web presentment gives members near instantaneous access to their detailed claim data when it’s convenient for them. Online statements also provide members with convenient management of their information, eliminating the need to keep track of paper statements and, possibly, the need to make a phone call to get needed information.

There are regulatory and security concerns surrounding ESP that can influence how an ESP capability is implemented. Aetna has responded to those concerns in three key areas.

First, the insurer designed the electronic statements to be identical in appearance to their paper counterpart. Second, the firm will continue processing paper-based EOBs along with the newer electronic versions for the foreseeable future. And third, Aetna created one of the most secure processing capabilities -- with advanced intrusion protection and dedicated closed-loop systems -- ever built.

A Long-Term View
In fact, Aetna's substantial commitment to security underscores the long-term view that it is bringing to its new ESP capability. While much of the hype surrounding ESP and EBPP centers on fast implementations and quick profits from cross-selling, Aetna prefers to take a far more deliberate approach. It views the technology as a way to nurture a 'partnership' relationship with both its members and Pitney Bowes docSense, the firm that developed and is helping to host the capability.

As for their specific ESP solution, Capasso says Aetna used four key criteria to guide the implementation: compatibility, portability, simple pricing, and proximity.

"The solution had to match our internal architecture and be capable of converting print files to XML as well as support output in various formats, such as PDF, HTML, PostScript and fax," says Capasso.

Aetna also wanted portability, due to the uncertain regulatory environment, especially the ability to move the solution in-house if it were required to do so for auditing or other security concerns.

Simplified pricing in the form of a 'pay as you go' formula was important as well because Aetna wanted to avoid any huge up front charges, and the concern that can come if member usage rates don't immediately justify the investment.

Lastly, the firm valued proximity, or a local installation with abundant near-by support. "We saw no advantage to using servers in Chicago or Los Angeles when we're in Hartford," says Capasso. "The cost and potential delay involved in transmitting sensitive data over long distances just didn't make sense to us.

The electronic statements are one of the many features of Aetna's secure member website, Aetna NavigatorTM, an online tool that provides an array of award-winning health information as well as the ability to help members better navigate their health plan details and related self-service transactions.

"We think ESP offers immense long-term value to our members and our business," adds Capasso, "and we are using Pitney Bowes' innovative technology to help create and sustain lasting relationships."

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