Abandoned MultiValue to SQL conversion - Oxford Health


High-Flying HMO Modernizes, Crashes

Oxford Health Plans Inc. was the Netscape of health maintenance organizations. It seemed to burst from nowhere, captivate customers and force competitors to change the way they operated. Then Oxford decided to modernize its information technology.
It was 1995 and Oxford's old turnkey, Pick-based billing and membership tracking system would no longer do. A complete overhaul, using more modern Unix technology, is what the company wanted - and fast.

The project included many custom applications that ran with Oracle databases and other software. But key was a claims processing system, dubbed Pulse, that Oxford's internal IT people built with Oracle tools.

Trouble hit the Trumbull, Conn.-based HMO almost as soon as the rollout started in late 1996. Customers suddenly got claims laden with errors - when they got claims at all. The company paid bills it shouldn't have and denied claims it should have paid.
All the late and inaccurate paperwork caused New York state to fine Oxford $3 million for violating insurance laws.
Overall, the new software overestimated revenue by $392 million for 1997 and 1998 while also underestimating medical costs. That awful combination led to Oxford's $291 million loss in 1997.

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