Quest for excellence
Operational excellence is a guiding principle in healthcare, and CareSource consistently outperforms industry benchmarks in key performance metrics. The healthcare organization administers one of the largest Medicaid managed care plans in the United States and also offers Health Insurance Marketplace and Medicare products.
To drive greater efficiency in service operations, CareSource sought a new solution that would centralize and automate service requests and change management, which both depended heavily on complex, manual processes. Envisioning a platform that could grow with company needs, CareSource chose ServiceNow to accelerate automation, transparency, and knowledge sharing to get more work done faster and more reliably.
Sparking broad interest within CareSource, ServiceNow easily serves dozens of functions across the organization. As Rob Sherman, CareSource ServiceNow Team Manager says, “ServiceNow is our foundation for internal business services, making workflows robust, efficient, and resilient.”
Beating reporting deadlines with better process visibility
As a government-sponsored healthcare organization, CareSource must submit member updates and claims to each of the eight states in its coverage area. Facing steep sanctions if deadlines are missed, CareSource needed a better way to produce reports on time. Using ServiceNow IT Operations Management (ITOM) to collect and correlate data about batch jobs and how long they take, including gaining insights into delays from manual tracking, CareSource identified and fixed problems in batch workflows, driving the failure rate down from four days per week to zero.
Built on IT Service Management Professional, the CareSource operations intake portal centralizes service requests, replacing emails and SharePoint. The portal brings service and operations teams together on tasks, tracking against SLAs for P1 and P2 incidents. CareSource uses ITOM to discover, manage, and correlate events, generating service tickets to fix incidents before they impact end users.
For change management, data from ITOM populates CMDB, and users from disaster recovery groups and others manage crucial configuration items. A big migration project brought mobile and laptop configurations into the CMDB. “It was night and day in terms of how quickly we could respond once we had all our configuration items,” says Alex Yaney, Technical Architect at CareSource. “Tickets get routed properly and completed faster.”
P1 incidents fell to less than one per month across the company. “ServiceNow has opened people’s eyes to see what happens in service operations and how that can impact the company’s operations,” says Tracey McKnight, Technical Architect at CareSource.
CareSource also aligned regulatory issues with operational issues, enabling staff to see all issues in one place—saving $200,000 and improving overall operational efficiency. The security team now tracks all its issues within ServiceNow and uses flows they built to automate working with different teams. “Everything just works better together,” says Yaney.
“We consolidated multiple tools and integrated with some of our customer service systems when we went to ServiceNow, allowing IT and business users to get the information they need in the most effective way,” says McKnight.
Responding at scale to vulnerabilities and security incidents
CareSource uses Security Operations to accelerate response time for vulnerabilities and security incidents. Where in the past patching was ad hoc or OS-based, CareSource now identifies groups of systems with the same vulnerability and patches them all at once.
Vulnerabilities are assigned to teams that own affected devices—a process previously managed using spreadsheets and manual assignment. Depending on criticality, remediation timing can be within 30, 60, or 90 days, and retesting confirms completion. When needed, the security team applies policy exceptions that set the vulnerability aside until the exception expires—a much easier and more secure process than the manual one it replaced.
“With ServiceNow, we have visibility to impacts across all infrastructure and services, plus data to show status, action plan, and remediation history during audits,” says Bill Fellner, Enterprise Architect at CareSource.
Extending security and governance across the enterprise
Integrated Risk Management has become the backbone for governance, risk, compliance, and security replacing many manual processes formerly managed by CareSource in SharePoint, Excel, and one-off meetings. Third-party Risk Management tracks remediation efforts, and the security team conducts internal risk assessments that gather data for analysis.
CareSource works under very strict regulatory compliance parameters. By automating 231 internal IT and 350 to 380 security-related controls and indicators with ServiceNow, the company saves roughly 20 hours per quarter just for the validation step.
By tracking time against indicators, the security team gains insight into areas for process improvement—something not practical in the old way of working. CareSource now aligns controls to the NIST framework and others to aid during auditing.
To maintain its SOC 2 and HITRUST certifications, CareSource completes vendor assessments and adheres to strict deadlines according to contractual obligations with each state. With many downstream vendors, CareSource has a responsibility to quantify the associated risk of PHI loss. CareSource uses Third-party Risk Management to facilitate fast response and tracking.
Moving to ServiceNow saves about 12 hours per week, streamlining intake, assessment, and reporting. The team also saves time and increases visibility by connecting to Security Scorecard and pulling metrics into security dashboards.
“It’s much easier to manage third-party risk with ServiceNow than with a spreadsheet as we used to do,” says Regina Dillon, Senior Manager of Information Security Third-Party Risk at CareSource.
Driving new efficiencies in software licensing and compliance
CareSource gained tremendous value from building a solid understanding of the software used in its environment and a preliminary view of its base license position. Over-licensing fell, and the company avoids potential penalties by validating its compliant position and adding licenses to make up for shortages where needed.
Using IT Asset Management integrated with scanning software, CareSource tracks whether installed software is being used and if there are spare licenses to deploy via inventory management. Installation data populated into CI records lets CareSource track on a per-device basis, and this data is used for renewal planning and right sizing.
Putting strategy into projects
Business and IT projects enjoy greater visibility with ServiceNow, helping managers stay on track from a capacity, resource, time, and budget perspective. As CareSource moves toward an iterative cycle of monthly planning, it gains greater control and confidence.
“We have visibility into where everything is in the demand process,” says Corianna Mossberg, Manager for Enterprise Project Management Governance at CareSource. “We can easily see what task is in motion and whether it is late or on target. Those are critical insights.”
CareSource automates and streamlines project tasks following simple industry-standard practices. The team also created an audit dashboard for scoring, performance evaluation, and comparison of actual against scope, schedule, and budget. Bringing all project information together in ServiceNow, CareSource retired half a dozen tools and 35 separate data stores.
“We were mainly running waterfall processes in Excel, Microsoft Word, SharePoint, and Microsoft Office products,” says Mossberg. “We moved everything we possibly could into ServiceNow.”
The quest continues
CareSource continues to steadily expand the scope and reach of the ServiceNow platform into IT operations, change, risk, projects, vendors, security, and audit—compounding the benefit by combining and leveraging across the organization.
“Almost half of CareSource already uses the ServiceNow platform as the primary tool for how work gets done,” says Sherman. McKnight adds, “What strikes me is how many people, once they saw what’s possible with ServiceNow, wanted to start using it.”
