several of the incompatible and inconsistent software tools
we had been using for years because they did not offer the
scalability, flexibility or personalization options we sought.
To address these requirements, we chose Hewlett-Packard’s
Exstream, which was broad enough to present customer documents and communications in a variety of ways, including
print and Web. In addition, it was easy to integrate with
Humana’s existing databases and corporate systems.
Using the new solution, we began producing
our redesigned EOB statement, SmartSummary.
This highly personalized document combines
carefully planned white space and full-color
images with targeted messaging that helps our
members make more informed decisions about
how to manage their health care benefits.
To produce the SmartSummary, the HP
Exstream software draws data from our
member databases. It then incorporates colorful icons, images, tables, graphs, charts and
other design elements to visually communicate information such as benefits usage, co-pay
amounts, medical articles, health and wellness
coupons, and suggestions on how to lower
With a clear view of who paid what, members
can easily see what they are responsible for and what their
plans paid toward the medical expenses. The SmartSummary
also displays a detailed explanation of how plans work, so
members can see what they’ve spent toward their deductible—both in-network and out of network—and what they
have paid out of pocket for medical and prescription claims.
We can also use one of our flexible design templates
to communicate with members across a variety of plans,
whether individual or group. For members with families, the
household view within the SmartSummary combines family
data in one statement for the current period and year to date,
allowing families to view spending totals (in-network and out
of network) and cost details by family member.
On average, a family of five that was previously receiving
more than 139 pages of traditional EOB documentation
annually now receives 39 pages of SmartSummary pages
over the course of the year. Even though the EOB has nearly
70 percent fewer pages, it provides more usable information
in a format that is easier for our members to understand.
With the flexibility of this solution, we also developed
the SmartSummary Rx, a monthly benefits statement summary tailored to Humana’s Medicare members. As a result,
Humana became the only company that does not use the traditional black-and-white EOB for Medicare beneficiaries. The
SmartSummary Rx provides Humana’s 4 million Medicare
enrollees with a comprehensive record of prescription claims
that includes helpful information, such as full-color pictures
of pills, dosage, previous refill dates, and prescribing doctor
and pharmacy information.
With these tools, Medicare enrollees can more effectively
communicate with their doctors and pharmacists about medications to help avoid potential harmful drug interactions and
also receive guidance about lower-cost medications that their
plans cover. SmartSummary Rx also gives an enhanced level
IMPROVED MEMBER SATISFACTION
By personalizing and automating the production of customized EOBs for our 4 million Medicare drug benefits
members and our 1.1 million commercial members, we are
able to communicate more effectively with
them. Our initial research compared retention rates of members who received the newly
designed statements to a control group of those
who did not. Members who received the new
statements were 14 percent more likely to say
they would renew their Humana plan. They also
reported that they were 7 percent more likely to
We also tracked calls to a dedicated member-service phone number for inquiries about our
new statements. For members receiving the
SmartSummary, calls to that number lasted 390
seconds, on average. That’s 15 percent less than
calls from members receiving the older EOB
statements, which lasted an average of 420 seconds. Decreasing the demand on our support
center is significant because Humana’s member-service department receives about 80,000 member-service calls per day.
We also are managing white space and blank pages better
in order to deliver valuable and relevant content. We are able
to combine communications into a single document when
it makes sense to do so, cutting production costs by up to
$250,000 per month. If a prescription drug comes off patent,
rather than mail a separate notice, we can now include the
notice in our SmartSummary Rx. By integrating these types
of communication in our EOBs, we’ve saved several million
dollars a year, primarily in postage costs.
Today, we continue to transition other document-produc-tion workflows to the HP Exstream environment, as our business success depends on how well we communicate with our
members. In five years, our SmartSummary statements have
allowed for an industry-transforming innovation that changes
decades of bland document delivery with a communication
that is personalized, more informative and highly relevant to
Our brand promise is to provide guidance to our members
when they need it most. By transforming the composition
and information contained in the EOB, SmartSummary and
SmartSummary Rx not only deliver on that promise, they
also redefine how we communicate with customers who for
years have been requesting more personalized and actionable
communications guidance from us.
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director of strategic
of control to each member by helping them track how much
they’ve spent on prescription drugs, enabling them to budget
for future health care and prescription spending.
Christopher Nicholson, director of strategic communications for
Humana, has a background in telecommunications, retail and health
care. He has an MBA from the University of Louisville, Ky.
BASELINE JULY/AUGUST 2010