migrate MA systems

How the World’s Largest PBM Leverages Vendor Specialty Pharmacy Knowledge to Better Serve Customers

migrate MA systems
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AgileThought Successfully Migrates M&A Systems, Prevents Duplication, and Develops Patient Portal at a 90% Lower Bid than the competition

Specialty Pharmacy Merger System Integration

The world’s largest pharmacy benefits management organization (PBM) was in the process of acquiring a leading specialty pharmacy group. The go-forward platform had been owned by an incoming subsidiary. The PBM had hired AgileThought to consolidate multiple systems and processes for the newly formed specialty division.

System integration is a normal function of mergers and acquisitions. Part of the new mission was to ensure that service to patients and network pharmacies would be uninterrupted. An incoming customer, the largest affected by the merger, had not yet been transitioned. They required that the PBM build a self-service patient portal where patients could order refills, and check their prescription and shipment statuses.

The new customer could not be migrated until the requirement was met.

The Challenge – Meet Incoming Customer Requirements Fast with a Minimal Footprint

The PBM would need to flesh out their existing specialty pharmacy patient portal within the context of the go-forward system. Vendors from both sides of the merger were asked to solve the challenge quickly. Two options emerged:

A) AgileThought Quote
The AgileThought project team, having already been working on system integration, understood specialty pharmacy, and what it would take to create a secure customer-facing portal within the go-forward system.

B) Competitor Bid
One vendor group suggested a system rewrite. This group lacked knowledge of the current systems, business unit, and processes involved, and thought that starting over on their terms would yield the best result.

Choosing the Digital Strong Path

The opposing vendor group had a much broader scope, but they could not figure out how to narrow the focus to meet the new customer’s requirements.

AgileThought already knew:

  • What was available from a technology standpoint
  • How to develop the new patient portal using parts of the previous project
  • What was critical and what was not

The team advised the specialty pharmacy division on the decision to determine what was necessary for the go-forward system vs add-ons.

An added risk of rewriting the platform was that the specialty division would run two platforms until the five-million-dollar rewrite was finished. Running multiple systems is complex and comes with a high cost. The PBM would face duality across subsidiary groups, and would have to maintain those applications.

They saw AgileThought’s option as a faster way to meet customer requirements at a 90% lower bid than the competition, and within a manageable timeframe.

AgileThought leveraged knowledge of specialty pharmacy processes, of the go-forward system, and of the business to create the new patient portal.

Navigating Issues Along the Way

The integration required more than process improvement, writing software, and data migration. There were hardware requirements and dependencies on people that were out of AgileThought’s control.

The AgileThought team had to make sure they were working with the right people in the Purchasing department to provision servers and other hardware.

An outward-facing portal also has larger security requirements, and so the team needed to also work with security to meet operational compliance standards. The AgileThought team overcame complexities by making sure they understood who to work with, and managed those relationships to stay on track.

Delivered Under $500,000 and Within 5 Months

The AgileThought team delivered the customer portal, and migrated the incoming customer, under $500,000 and within five months. The PBM specialty pharmacy division runs one system as intended without having to deal with duality and waste.

How Knowledge of PBM Business Drives Innovation

It’s one thing to claim that you can help a company save money, it’s an entirely different thing to predict that you can save them a million dollars, and come out the other side, demonstrating with data, that you’ve accomplished (or surpassed) it.

For this merger, the PBM specialty division wanted a fast solution with minimal footprint. Preventing system duality was a secondary goal. AgileThought was able to develop exactly what was needed to move forward, faster.

The risk of hiring a vendor who doesn’t learn the business – processes, systems, and goals – is that they make assumptions. A vendor can, for example, take an already-efficient process and add extra steps to put their stamp on it, adding unnecessary layers of complexity.

The alternative proposal would have taken years, and may have never met the customer’s requirements. The customer had to have the patient portal ready by the end of the year. They had a deadline, and there was no way that they would make that deadline with a full rewrite.

Why More Fortune 1000 Companies Turn to AgileThought for System Integration

The path to digital transformation involves a large investment and technology changes. AgileThought ensures customers are prepared to meet those changes by optimizing their current systems and processes so that, when they do upgrade, they know exactly what to expect.

AgileThought has been a partner of this PBM for over fifteen years, and has helped them save tens of millions of dollars in productivity benefits.

Download The Success Story!

migrate MA systems

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