Bupa: Personalizing healthcare journeys with Pega Customer Decision Hub
year-over-year improvement in engagement
digital processing of claims
returned to members
The Business Issue
Bupa, a global healthcare provider, aimed to transition from a traditionally private health insurance–led model to an integrated healthcare provisioning model. This required a robust digital transformation to enhance customer engagement, streamline operations, and deliver personalized healthcare experiences. They faced the challenge of integrating their diverse healthcare services and insurance offerings across multiple regions, each with unique regulatory and market conditions.
The Solution
Bupa partnered with Pega to implement Pega Customer Decision Hub™, aiming to unify customer data, personalize engagement, and optimize service delivery across its various business units. The transformation journey included:
- Target state architecture: Mapping out a comprehensive target state architecture to align all business units around a common customer engagement engine.
- Digital integration: Integrating digital channels to enable seamless customer interactions and service delivery.
- Personalization: Using Customer Decision Hub to deliver hyper-personalized health propositions and services, enhancing customer satisfaction and engagement.
- Operational efficiency: Utilizing AI and automation to streamline workflows, reduce time to market, and improve operational efficiency.
The Results
Bupa’s implementation of Pega Customer Decision Hub led to significant improvements in customer engagement and operational efficiency:
- Enhanced digital engagement: Achieved nearly 100% digital processing of claims, with zero-touch interactions becoming the norm.
- Increased personalization: Saw a 50% year-over-year improvement in engagement for personalized health programs, such as mental health and post-maternal care.
- Operational efficiency: Realized up to 50% reduction in time to market for new personalized content and services.
- Customer satisfaction: Maintained high Net Promoter Scores (NPS) across various services, particularly in dental care.
- Financial impact: Returned over $1.3 billion to members in premiums for unrendered services during the COVID-19 pandemic, driving tremendous retention results.
Dive deeper into their journey in their PegaWorld 2024 session.
Decisioning done in real time.
Hyper-personalizing every digital touchpoint.
“We've seen great success with just that shift from product to customer [centric approach], trusting the data. And [Customer Decision Hub] has been the key for us in unlocking that as the organization.”