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hospital cases handled every year by AOK.
AOK is Germany’s largest health insurance fund, and for over 130 years has guaranteed high quality medical care for its approximately 24 million members. With over 53,000 employees in over 1,200 offices — they ensure members receive all the services needed: quickly, competently, and without bureaucracy. SAP helps AOK to service their customer better.
SAP HANA database, SAP Customer Relationship Management
The electronic patient’s card is every AOK member’s key 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. Except for a small co-payment for prescriptions, doctors’ appointments are free of charge — regardless of how often the patient needs a consultation — and, patients are free to choose their own doctor. Every person covered by statutory health insurance in Germany pays a contribution rate of 15.5 per cent of earnings, set by the state.
AOK intended to analyze patient, prescription, and insured data to find patterns that could increase the likelihood of an illness later in life. Then, they could reach out to the insured right away and offer preventive care, thus hopefully preventing future illness.
“A health insurance fund should really be two steps ahead as opposed to being there to only solve problems.”
AOK chose SAP’s in-memory database solution to run an efficient business and at the same time attract more clients. And because of that solution it manages its operations efficiently and in turn can reinvest a large portion of the standard premiums contributed into improving services for its clients.
Originally, the idea of developing the software landscape on their own didn´t work — so AOK required a standardized solution, and chose SAP for this endeavor based on previous positive experiences with SAP. Later on when the millennium came, they were looking for a way to further develop the landscape. And then it was time for a re-orientation and a proof of concept with SAP. The outcome of that was the industry´s standard solution named oscare®.
SAP is the multichannel management of all technical processes, and has a fully developed campaign management as well as an integrated reporting and monitoring.
With SAP CRM, AOK provides a scalable platform for health insurances, which proves hopeful for stabilizing customer loyalty and attracting new customers.
Thanks to oscare®, AOK consolidated its own processes and is now positioned so well in numerous national subsidiaries that it can win even more clients in the liberalized German healthcare market. This is because it manages its operations efficiently and in turn can reinvest a large portion of the standard premiums contributed into improving services for its clients.
And, with SAP CRM, AOK is able to communicate with their customers through all channels as well as efficiently convert huge volumes of data.
AOK works hard to provide its members with a better standard of health care. For instance, it has developed its own structured treatment programs for people with chronic diseases. These programs benefit from scientific monitoring and evaluation, and an integrated quality management system to ensure their constant improvement.
It sets standards in other fields, too. Integrated care is a good example. Different stages in treatment — doctor’s surgeries, hospital, nursing homes or rehabilitation — are coordinated for maximum efficiency. Patients are spared duplicate procedures and therapy is more effective.