success story

Greater Medicare Advantage membership retention

Through in-sourced marketing and effective transformation leveraging Pega CDH

A regional blue healthcare payer relied on an external vendor to manage its marketing data. The information was vital for the client to offer new products and benefits for prospective onboarding members and retaining existing ones. They also utilized their data cleansing and de-duplication services. The client’s over-dependence on the external vendor started causing many issues, such as high recurring annual costs, siloed data stores, and the lack of specialized data, reporting and visualization, personalized marketing, and integration with heavy inbound and outbound channels. It also made it difficult for the client to change the existing process or launch a new campaign. 

With Virtusa's Pega Marketing Framework built for payers, we successfully implemented an in-house marketing database and Pega Customer Decision Hub (CDH) for our client – a leading regional payer. With this database, our robust solution successfully replaced the expensive external vendor while creating an opportunity to enable next-best-action recommendations in the future.

The Challenge

By relying on an external vendor to handle its marketing data, the client could not respond to marketing needs promptly, resulting in a lower conversion rate of commercial members to medicare advantage plans. 

The client faced other critical issues, including: 

  • No access to real-time marketing data   
  • The high recurring annual cost
  • Lack of process transparency
  • Inability to identify new prospects from current members
  • Inconsistency in keeping customer contact history for future marketing campaigns 
  • Lack of personalized and targeted marketing campaigns
  • Heavy dependence on the integration with the external vendor 
The Solution

Implementing an in-house marketing database and Pega CDH

Virtusa used a two-phase implementation process to create the ideal solution for the client. We eliminated the client's dependency on the external vendor by implementing an in-house marketing data store in the first phase. In the second phase, we implemented Pega CDH (Pega Marketing) to identify the target customers for potential product sales to build marketing campaigns. 

Pega CDH accepts data in a CSV format, allowing data integration from additional and external sources. When the marketing data gets uploaded to the solution, it identifies the most appropriate customers based on the set criteria and rules.

The marketing department can now access the data stored internally and use it in real-time, with specific criteria and rules, to execute marketing campaigns to reach business goals. 


Greater Medicare Advantage membership retention solution
The Benefit

A phased approach to bringing the necessary tools in-house

Using Virtusa's Pega Marketing Framework, our client brought marketing data management in-house to save around $900K. The implementation is targeted to achieve a 50% increase in conversation rate.

Additionally, each phase of implementing the marketing database and Pega CDH provided a tremendous value add. The client gained: 

  • Transparency in marketing operations
  • A state-of-the-art in-house marketing database across LOBs
  • Improved data quality by harmonizing, cleaning, and de-duplicating prospects ta received from various feeds
  • Independence in marketing operations by eliminating external vendors 
  • A fully integrated system that leverages additional and extra data sources and drives omnichannel marketing

The solution also sets the client up for a wide range of future opportunities, like: 

  • Implementing next-best-action (NBA) and new channels, including  SMS, mobile, and web
  • A real-time dashboard that projects insights and analytics 
  • Learning through contact history captured in their marketing data store
  • Dynamic content for personalization
  • Approaching the right client at the right time through campaigns and other marketing activities 
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