Case Study: Full-service Health Benefits Company achieves $3.7M in savings and major productivity gains with ZeOmega’s Jiva

ZeOmega’s Jiva Helps Top Health Plan Increase Productivity, Improve Efficiencies, and Save $3.7 Million

Health Benefits Company, a full-service health plan serving more than 1 million members across New England and nationally and long ranked by NCQA as a top private health plan, faced an aging homegrown technology platform that could not keep pace with regulatory changes, reporting needs, or evolving care-delivery models. The organization needed a flexible, configurable system to automate member identification and staff assignments, standardize assessments, maintain NCQA compliance, and improve productivity—so it evaluated solutions including ZeOmega’s Jiva population health management platform.

ZeOmega implemented Jiva as a single, in-house platform, using its configurable Sentinel rules engine to automate member ID rules and staff assignments and to integrate disease management, case management, social work, and appeals workflows. As a result, Health Benefits Company realized nearly $3.7 million in administrative cost savings from insourcing, a 25% reduction in full-time equivalent employees per 1,000 members, a 40% reduction in administrative support staff, improved care identification and outcomes, and higher employer satisfaction—outcomes the customer attributes directly to ZeOmega’s Jiva.