Case Study: Leading Health Insurer achieves integrated regulatory compliance and slashed reporting time with MetricStream

Leading Health Insurer Integrates Regulatory Compliance Efforts, Saves Time and Costs

A leading health insurer faced a major compliance challenge after the 2010 PPACA expanded federal oversight of its entire book of business. Its legacy approach—disparate papers, spreadsheets and shared drives—was inefficient, error-prone, and lacked coordinated regulatory monitoring, a common taxonomy, or enterprise-wide visibility across HIPAA, MAR, the Michigan insurance code and other rules.

The insurer implemented the MetricStream Integrated Risk Platform and rolled out integrated GRC modules for compliance, regulatory change, risk, policy, case, and internal audit management. This created a single source of truth, automated workflows, and standardized processes—delivering over 200 qualified metrics for decision-making, enterprise-wide transparency, rapid reporting (reduced from 30 days to 2–3 days), and scalable case and audit management used by thousands of users.