Customer Snapshot: Overview
Insuring 24 million people across Germany
AOK, the market leader in Statutory Health Insurance (SHI) in Germany, has guaranteed quality medical care for policy holders for over 130 years. With help from SAP, AOK Systems – the IT division of AOK – created a cross-industry solution designed to cover all the core and support processes typical of a statutory health insurance company. This solution enables SHI companies to optimize spending, comply with all government mandated regulations, and help more patients gain access to special treatment programs and preventative care.
Number of Employees
Line of Business
SAP Business Suite, SAP Business Warehouse, SAP Custom Development, SAP Customer Relationship Management (SAP CRM), SAP ERP, SAP for Insurance, SAP HANA
Customer Snapshot: History
Customer Snapshot: Business Model
The SHI system has proved a successful model in Germany for almost 130 years. And today, AOK is the largest SHI in the country, representing 35% of market share. With an electronic patient’s card, every AOK member has access to all the services their health insurance fund provides. The "benefits in kind" principle guarantees that people with health insurance never have to pay for doctors’ services themselves. Patients are free to choose their own doctor and how frequently they need to see that doctor.
The AOK offices are the first point of contact for members with any questions about their health insurance coverage. Over the phone or face to face, AOK also provides experts to advise members on a vast array of health issues.
Customer Snapshot: Success Strategy
To combat a never-ending pool of incoming data, AOK needed a solution that could process data quickly and in an easily comprehendible manner.
Combatting competition, ever- changing government policy, and rising costs.
All SHI providers in Germany are dedicated to preserving the health of policy holders by providing the best treatment possible. But with premiums mandated by law, competition among insurance providers is fierce.
Implementing IT solutions that can handle the volume.
And competition is only one of the challenges that SHI companies face. The changing demographic in Germany is leading to rising medical costs, so cutting internal costs is incredibly important. Further, each change in government policy requires an update in the company’s IT systems.
In addition to helping control costs, AOK required an IT solution that could handle very large amounts of data. Collectively, 11 independent regional AOKs manage 6 million cases of clinical treatment, 370 million cases of medical treatment, and 400 million drug prescriptions annually.
Currently oscare® runs SAP Business Warehouse powered by SAP HANA, but in their SAP HANA roadmap, AOK Systems outlines their plan to move their other SAP components onto the SAP HANA platform, such as the SAP ERP application and the SAP Customer Relationship Management application.
Enter SAP: The SAP Experience
With SAP BW powered by SAP HANA running on the backend, oscare® is able to analyze and process the huge amounts of data running through AOK on a daily basis. AOK now has operational analytics to optimize processes. In addition, AOK now is able to better design disease prevention programs that protect and improve the health of insurance holders.
The difference SAP HANA is making.
Better Business: Benefits
Patient care programs have benefited too. Evaluating diabetic foot syndrome can be a complicated and time-consuming process. With their new systems in place, AOK has reduced the evaluation processing time for this condition from 150 hours (about 6 full days) to 15 minutes. This rapid analysis of the data makes it easier for AOK to design optimized care programs and to get help out faster to the patients who need it.
Since SAP HANA was implemented, scores and scores of ideas have arisen with possibilities in terms of new business models, new chances, new possibilities of evaluation, and new support for the processing team…. SAP HANA obviously helps the policyholders of AOK because now AOK can develop ideal prevention and care programs.–Udo Patzelt, Head of Product Management at AOK Systems
Better Business: Run Simple
For AOK members, this constitutes the best possible health care at an affordable price.
AOK plans to migrate their entire oscare landscape to the SAP HANA platform, and they will further enhance their system with additional functionality. These enhancements should help AOK continue their mission of enabling millions of German citizens to receive quality heath care.
Planning for the future.