Case Study: Large Healthcare Company achieves real-time member insights and faster care outreach with Appian

Large Healthcare Company - Customer Case Study

A large, multistate healthcare payer with more than $10 billion in revenue, 10 million members and 15,000 employees faced difficulty coordinating timely outreach to high-risk members. Risk identification relied on manual SQL analysis and macros to produce flat files for different channels, and processes lacked transparency and accountability—making it hard to know why or how members were contacted, how their health was trending, or which outreach channels had been used.

Using the Appian platform to integrate people, process and data, the payer automated care orchestration: consolidated data across sources, prioritized outreach across 130+ conditions, and applied business rules to select appropriate channels and care paths. The solution delivered a real-time view of member health and outreach history (previously a 60+ minute process), shortened member homepage updates by 48 hours, and reduced the age of open cases by one day, supporting better outcomes and lower costs.