MVP Health Care uses Dynamics 365 to personalize member support, promote healthy communities

Better patient outcomes, lower member rates

MVP Health Care makes health insurance more convenient, more supportive, and more personal. Committed to making a positive impact on the health and wellness of the communities it serves, the regional not-for-profit delivers on its brand promise for each of its 700,000 members.

As a healthcare payor, MVP Health Care wants to help its members obtain high-quality, cost-effective care in an efficient way that is convenient for them. To help minimize high-level claim types such as heart attack, stroke, and diabetes, MVP Health Care monitors and manages its membership through programs designed to capture early diagnoses, reduce or prevent complications, drive better patient outcomes—and lower member rates. 

But employees struggled to maintain and work with the organization’s legacy member-engagement environment, an unruly mix of aging, siloed systems pieced together from multiple technologies, data sources, and point solutions. To find information and serve members, service representatives had to sign on to more than half a dozen applications and work from up to 16 screens. 

Resolution often came slowly, and once it did, members sometimes received multiple contacts about the same issue. “Even if you send the right answer three times, it does not leave the best impression,” admits Michael Della Villa, Chief Information Officer at MVP Health Care.

The heartbeat of every member 

MVP Health Care needed more effective member engagement across all its practices. It also wanted to tie its transformation to larger initiatives in healthcare such as a common data language and interoperability across the industry. To do this, the healthcare payor needed to move its data from multiple, siloed systems to a unified, cloud-based member-engagement platform. And it wanted to use advanced digital technologies like AI and machine learning to improve business operations, while keeping patient outcomes its top priority. 

To improve internal efficiency, enhance member support, and outpace competitors, the organization’s leaders recognized that employees needed better access to more information. So MVP Health Care adopted Microsoft Dynamics 365 to help it tie everything together into one centralized data stream, streamline processes, scale elastically, and promote member value. 

“To deliver better member service and stay competitive, we have to understand our membership better, in the aggregate and as individuals,” says Della Villa. “With Dynamics 365, we can build a single view into the heartbeat of every member, while we deliver more interoperability to providers, partners, members, and employees.”

A centralized, comprehensive view 

MVP Health Care chose multiple Dynamics 365 business applications, plus Microsoft Azure and Microsoft 365, to create a centralized collaboration platform for its 2,000 employees and 700,000 members. It deployed Dynamics 365 Customer Insights with Dynamics 365 Customer Service, using Customer Insights to personalize its member engagements by unifying data from multiple sources for a single view of every member. 

If a member contacts the call center complaining of stomach problems, an MVP Health Care representative can use Dynamics 365 Customer Service to access the member’s health plan details and history, electronic health record (EHR) data, and other appropriate information. Then the representative can use Customer Insights to help recommend a procedure and help the member make an appointment with their existing doctor or an appropriate specialist. 

MVP Health Care combined Dynamics 365 Customer Service with Dynamics 365 Sales and Dynamics 365 Marketing to build a single, fully interoperable member-engagement platform, connected by Common Data Service. With Dynamics 365 Marketing, the organization can target campaigns and informational content to specific members or groups who may need help with their diabetes, sleep apnea, acid reflux, or other chronic conditions. Based on member medical histories and previous health plan engagements, MVP Health Care can provide targeted, relevant recommendations for lifestyle changes, sleep studies, and other pathways to wellness tailored to specific member needs.

“With a common data layer across Dynamics 365, we bring all the pieces together holistically and unlock visibility into our membership,” says Della Villa. “Then we can use the specific business applications in Dynamics 365 to tie our marketing and sales efforts to higher membership service and better patient outcomes.” 

Now MVP Health Care service representatives, sellers, and marketers feed EHR data, claims information, and other member data to Dynamics 365 through Azure. With Customer Insights, they build holistic profiles to derive AI-driven insights—based on the transactional, behavioral, and medical history of each member. 

“We’ve used AI and machine learning in Customer Insights to build a better understanding of our members,” says Darcy Baldwin, Senior Leader of IT Business Services at MVP Health Care. “That helps us get members the right information, recommend the best actions, and make better business decisions.”

With all the information displayed in one place on one screen, MVP Health Care employees monitor, understand, and adapt to the evolution of each member’s needs. The insights help them better address members’ changing requirements, personalize health plans, deliver accurate information, streamline member support, and drive business and clinical value. 

“If a member visits the ER right after an outpatient surgical procedure or another has missed appointments because they are housebound, we have the visibility in Dynamics 365 to see that and recommend appropriate actions, proactively provide transportation services, and otherwise help them manage their health,” says Della Villa.

More capabilities, better processes, and faster innovation

To extend the capabilities in its Dynamics 365 environment, MVP Health Care added Microsoft Power Platform to optimize business processes, streamline workflows, and complete tasks. 

The healthcare payor uses Power BI with Dynamics 365 Marketing to create campaign dashboards that marketers use to develop best practices, analyze outcomes, and drive enterprise strategy. With Power Apps, MVP Health Care supports low-code citizen development, so its business users can simplify and standardize member services themselves, improving the processes they understand best. An MVP Health Care business team has already used Power Apps to replace an old but critical BizTalk Server application, which meant the team could sunset a legacy domain. And with Power Automate, MVP Health Care has replaced previously manual workflows around renewals and compliance, which used to take days or weeks to complete, with streamlined, automated processes and increased visibility across these critical procedures.  

MVP Health Care also has complex medical and financial compliance requirements, which it addresses with security and governance tools in Azure and Microsoft 365. For example, it uses multifactor authentication in Microsoft 365 to help meet specific New York State financial compliance requirements for healthcare payors. Business and IT teams use Microsoft Surface Studio and Surface Hub devices for Scrum huddles and meetings, and MVP Health Care intends to deploy up to 1,000 Surface Pro and Surface Laptop devices across the organization.

MVP Health Care is working with its integration partner Hitachi Solutions—a member of the Microsoft Partner Network—to deploy its Dynamics 365 member-engagement platform to 1,400 users. As it moves forward, the organization will use the Microsoft Dynamics 365 Healthcare Accelerator to rapidly develop new solutions and workflows using a FHIR-based data model.   

From payor to trusted healthcare innovator

By building a member-engagement platform with Dynamics 365, MVP Health Care has obtained a universal, centralized view of its membership community and has launched its transformation from a healthcare payor into a trusted healthcare liaison. As it infuses AI and machine learning into membership processes, it can improve visibility and provide insights into clinical outcomes that will help MVP Health Care and its partners respond to member needs and foster healthy communities.

Meanwhile, the MVP Health Care IT team has more opportunity to focus on business and clinical needs and drive value to the health plan and its members. “With Dynamics 365, we can increase our pace of change and adapt proactively to shifts in the healthcare landscape,” says Della Villa. “We’ve empowered business users to standardize their processes and workflows with Power Apps and Power Automate, and that frees the IT team to create value for our business, our partners, and our members.” 

USD6 million in savings a year, more member value, healthier communities

Through scalable, reproducible, AI-driven process improvement, sunsetting legacy domains, and IT efficiency, the healthcare payor expects to save up to $6 million a year. It has standardized, simplified, and automated business processes, and by connecting marketing, sales, and rates to improved patient health, it has rationalized health plan incentives. MVP Health Care can now deliver services faster, to more members and more providers, while it maintains its business-critical compliance, data governance, and security standards.  

As the organization leapfrogs into a nimble future, it will continue to reduce costs, but its main drivers are flexibility, complete interoperability, ease of use, and member value. And with simple access to data in Dynamics 365, MVP Health Care employees will find it easier to help members resolve claims, make the right appointments with the appropriate clinicians, manage their health, stay well, and ultimately avoid undue medical costs. 

“Patient outcomes, member services, and rates signify a health plan’s effectiveness,” says Della Villa. “By implementing Dynamics 365, we know our members better, so we can meet our commitment to rational rates, personalized services, and healthier communities.” 

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Beginning September 1, 2023, Dynamics 365 Marketing and Dynamics 365 Customer Insights will merge into a single offering under Dynamics 365 Customer Insights. Learn more about the evolution of Dynamics 365 Customer Insights.