RPA benefits Insurance and Health sectors

The Benefits of Robotic Process Automation in the Insurance + Health Sector

RPA benefits Insurance and Health sectors

27th January 2021

The ongoing coronavirus pandemic accelerated digital transformation strategies, as companies have scrambled - with varying degrees of success - to meet new demands and to sustain existing business processes in a remote world. What may previously have been a 3+ year plan to automate became an immediate business need.

It should come as no surprise, then, that research by Bain & Company has found that roughly 84% of companies have taken actions to accelerate automation initiatives, including roughly 95% of Financial Services companies and 81% of healthcare companies:

Percentage of companies taking action to accelerate automation initiatives
Image Source: Bain

Interestingly, however, the same report by Bain notes that, “if history is any guide, fewer than 50% of these companies will achieve their automation performance goals.”

So what is it that determines whether an insurance or healthcare organisation will successfully embrace automation, while others fail? As Bain suggests, and as we’ve seen echoed in our work implementing automation with our clients at Converga, “Long-term success will depend not on automating a list of tasks, but on redesigning the work and processes with an eye toward automation and digitalisation where they will provide the greatest value.” Indeed what is needed is an automation first mindset through the entire business with a view to an automation endgame.

As an example, consider a robotic process automation (RPA) implementation. Although many different types of automation exist, RPA in particular is a software solution that can be used to automate repetitive, manual tasks through the use of attended or unattended ‘bots’, which can either complete manual tasks on their own or conduct them alongside human workers. Implementing these processes with the right partner and software means these functions are ready for Artificial Intelligence (AI) and Machine Learning (ML) to be integrated in the near future.

RPA tools can be a game-changer for some organisations, but it’s just as true that using them to replicate inefficient - or even unnecessary - processes represents a wasted investment. Yet, in their haste to automate everything possible and get ahead of COVID-related challenges, it can be tempting for some healthcare or insurance businesses to rush into poorly planned RPA implementations that ultimately fail.


Benefits of RPA for the Healthcare Sector

There’s no questioning that the healthcare sector has been hit especially hard by the COVID-19 pandemic. Amongst the particular challenges faced by these organisations include:

• Hospital backlogs in several different areas, including staffing, credentialing, patient care, and billing.
• Increasingly scarce resources, as well as the need to appropriately provision those supplies that can be accessed.
• An influx in demand, as hospitals and other care facilities navigate higher patient volumes and more complex medical needs.

This can be summarised largely in terms of, “we know what to do and how to do it, we just struggle to get it done on time,” which leads itself perfectly to business process automation with RPA.

Automation has the potential to support all of these challenges, yet its implementation is associated with its own difficulties. Tying back to Bain’s point about redesigning work and processes, one of the most common issues we see is the implementation of bad processes.For healthcare organisations that are able to move beyond these challenges, several potential benefits await.

Image of stethoscope

A 2016 McKinsey report put the technical potential for automation in healthcare work at roughly 36 per cent of all activities. While this value was at the lower end of the industries the firm surveyed, it also acknowledged a high degree of variability within specific roles. According to the report:

“Nursing assistants, for example, spend about two-thirds of their time collecting health information. Even some of the more complex activities that doctors perform, such as administering anesthesia during simple procedures or reading radio-logical scans, have the technical potential for automation.”

Adopting automation in these roles stands to improve the efficiency of healthcare workers, while also minimising the risk of human error. On the administrative side, automation offers even greater benefits.

Take the robotic process automation (RPA) implementation of Canon Australia’s banking operations. While not a healthcare organisation specifically, Canon’s size means its financial systems are similarly complex. By automating report generation, statement processing, B-Pay, and EFT management, manual processes that once took 15-20 minutes each can now be completed in just 5-7 minutes by robotic assistants.

RPA can assist healthcare companies in handling similar functions, but it can also be used to manage all of the following tasks, amongst others:

• Test kit processing, including corresponding paperwork
• New patient registration and health history capture
• Data reporting to governmental bodies
• Inventory and supply management for PPE
• Background checks and credentialing for new, demand-driven staff


Benefits of RPA for the Insurance Sector

Like healthcare organisations, the insurance industry is driven by a number of manual activities that can be automated through RPA.

According to Pankaj Chauhan, CEO and MD of EPOCH Insurance Brokers, in an article for DQ India, “(RPA) automates the mundane routine workflow of the insurance industry. Therefore, it reduces the workload and cost of operations and improves customer satisfaction. It also reduces the claims processes by automating the data collection process.”

Further, the two write, “when it comes to manual data collection and entry, it is a difficult task and could lead to inconsistencies and errors in data management. RPA simplifies the data management process at great speed.”

Specific insurance industry activities that stand to benefit from RPA include:

• Coordinating data between critical systems (including ERPs and CRMs)
• Collecting policy holder information from multiple sources for underwriting purposes
• Verifying insurance periods and other cover details
• Approving policies, claims and/or benefits according to predefined rules
• Identifying and flagging data mismatch errors
• Generating follow-up alerts for required actions

Image of umbrellas

Taken together, these activities can contribute significantly to an insurance company’s ability to remain in compliance with relevant guidelines, whilst also reducing operational expenses and improving productivity.


RPA-as-a-Service or RPA In-House?

Taking advantage of these and other benefits through RPA requires that organisations make a number of strategic implementation choices, including both the scope of the tasks to be automated and whether to handle the transition internally or with the support of a partner.

While we obviously believe in the value of having a steady, experienced RPA guide working on your behalf, we do want to clear up a misconception that automation programs must be ‘all or nothing’ to be effective. In fact, it’s quite common for organisations to select a pilot program and measure its results before beginning larger-scale implementations.

One of the ways Converga supports healthcare and insurance organisations in this more agile approach is through our “RPA-as-a-Service” offering.

A typical RPA implementation can take between 12-18 months as it proceeds from the selection of the partner and the implementation of the infrastructure and applications, through to testing, training, and iteration. RPA-as-a-Service, on the other hand, can be executed in as little as 6-8 weeks, with 1-2 week agile sprints to follow that further extend ongoing automation.

Many of the healthcare and insurance sector customers we’ve worked with at Converga share that they initially attempted automation implementation on their own, either by tapping into existing internal talent or even bringing on specialists in the area to work in-house for them. While the best-fit approach will vary from one organisation to the next, we’re big advocates for enlisting a specificialist partner.

Not only can a team like Converga leverage the successes they’ve seen with other organisations to improve your results, using their as-a-service model means you avoid many of the initial set up costs and delays due to building internal skills and IT investments required.

According to Ken Hickey, Head of Business Process Solutions at Converga:

Converga’s DNA is all about leveraging the technology we house to deliver the desired client outcome. We are seeing business move away from building subject matter expertise in non-core functions such as RPA on premise, in favour of an as-a-Service mode of deliver. In essence, companies enjoy all the same benefits without the need to build, train, maintain and support the applications.


Avoid Falling Behind with RPA

However you decide to embrace RPA, what’s most important is that it’s on your radar at this time, and that you’re preparing to execute it in a strategic way, based on your long-term business goals.

De’Onn Griffin, research director at Gartner talks to the challenge that CIOs have facing them across all industries,

“CIOs seeking to master the dynamics of leadership, culture and people during the next 10 years should go to the extreme and be daring. They need to create a 10-year scenario for “We Working,” and prepare for the combination of people + AI + robots in the workplace and how they will enrich and invigorate work dynamics”

For the healthcare industry, a May 2020 report from Gartner shows how roughly 50 percent of the healthcare industry in the US spurred on by the pandemic, and combined with the need to optimise costs and resources will invest in RPA in the next 3 years.

Even if we don’t immediately see the same trend in Australia, the message is clear: those organisations that fail to move now to address both the immediate challenges and long-term changes brought about by COVID risk falling behind more savvy competitors that are already leveraging RPA solutions.

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