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<Insert Picture Here> Oracle Policy Automation: Creating next generation unemployment benefit determinations, calculations and self service applications Peter Jeavons, Senior Director, Public Sector Industry Group, Europe, Middle East & Africa 2 December 2009

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Page 1: OPA For Unemployment

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Oracle Policy Automation:

Creating next generation unemployment benefit determinations,

calculations and self service applications

Peter Jeavons, Senior Director, Public Sector Industry Group, Europe, Middle East & Africa

2 December 2009

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Oracle’s Policy Automation

Oracle Policy Automation is focused on modeling, automating and optimizing the implementation of legislation and policy for public sector and other heavily regulated industries

� For 20 years Haley (Oracle’s Policy Automation software) has focused on public sector policy automation

� Dynamic self-service applications and high-volume enterprise automation

� Based on often complex policy and legislation

� Screening, eligibility and payment determinations

� The former Haley Office Rules suite is now Oracle Policy Modeling and Oracle Policy Automation

� The Oracle Policy Automation suite is recognized as a public sector leader by industry analysts

� Customers include the world’s largest government agencies in UK, Europe and North America

� Government agencies use Haley to serve tens of millions of citizens, both online and in batch processes

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• Social services is a critical focus for Oracle• Customers moving from custom software to Commercial off the Shelf (COTS)

packaged applications

• More than 1,100 agencies world-wide, with many expected to modernize their systems within the next two to five years

• With Policy Automation, Oracle will be a leader in social services • Oracle’s ERP and Siebel CRM applications are the leading front and back office

solutions for public sector

• Oracle’s Determinations Engine is unique in its capabilities for Social Services

• OPA is the core determinations engine of Oracle’s social services solution

Oracle in Social Services

Oracle’s Siebel CRM

Multi Channel

Case Management

OPA’sEligibility

Policies, Laws

Circumstances etc

Oracle’s ERP

Payments

AR/AP

Citizens

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Dynamic legislation drives the need to automate policies

Freedom of information is increasing the

pressure from customers and citizens to

prove compliance with policies and

standards

Budgetary

pressures force

efficiencies

Costly IT projects and resource-intensive

call centres are expected to innovate, and

deliver more with less

Accountability

requires

transparency

Security, geopolitical and financial events

drive frequent legislative changes and high

expectations of enforcement

Making accurate and consistent decisions

is difficult when finely targeted policies are

needed to deliver the best outcomes

Policy

complexity is

growing

Legislative

changes are

accelerating

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•Business users

create the

content

•Unique tools

check rules &

show

implications

•Quick, high

performance

deployment

• Business people write rules in Natural Language and therefore no cost or risk associated with translation by IT

• Manage rules with business tools like Microsoft Word, Excel, Visio reduces training requirement and allows for agility with updates

• Policy Isomorphism providing confidence in and visibility of rules

• In-built simulation and scenario modelling gives capacity to

analyse and test policy and rule outcomes

• Detailed determination reporting documents how conclusions

were reached for audit purposes

• Automated and interactive rule testing to ensure that

deployments give correct results

• Fully SOA-enabled out-of-the-box providing low cost flexibility

• Integrated with Siebel

• High performance inference engine with Temporal Reasoning

architecture

Policy Automation Value Proposition

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Policy Automation benefits

• Dramatically improves time-to-market for changes to

policies and rules

• Simplifies development and maintenance

• Ensures accuracy and consistency in complex

decisions and determinations

• Reduces the burden on IT resources

• Assesses the impact of changes in policy on

customers and citizens through “what if” scenarios

• Provides full audit-trail capability

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Key Enabler: Policy Isomorphism (Patented)

The Source

Legislation or

Policy

Executable Document in Natural

Language that Business users can

understand and modifyCopy, Paste, Markup

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Key Enabler: Dynamic interactive interviews

•Asks least

number of

questions in most

logical order to

finalize a

determination

•Questions

automatically

created from

source document

without need

for any

programming

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Key Enabler: Determination Reporting

Positive and

Negative

statements

automatically

created to explain

determination

Can be used to

build the content

for a letter of

advice or audit

Natural language

engine provides

personalization

and pronoun

substitution

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Key enabler: Temporal Reasoning (Patent Pending)

• Efficiently handle changes in:

• Eligibility, e.g. a change in minimum age, which takes affect on a certain date

• Rates, e.g. quarterly increase of a benefit rate

• Customer circumstances, e.g. number of children, marital status

• Benefits of the Oracle Policy Modelling approach to temporal reasoning:

• Accurate calculation of payments even when notification is retrospective

• Expressing time-based logic is simple and concise

• Optimal performance, without forgoing transparency or decision audits

Annual

rate

increase

Annual

rate

increase

Annual

rate

increase

Claimant is

married

New childPay riseNew

child

New

eligibility

rules come

into effect

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Key Enabler: Policy Visualization

Quickly find

dependencies

across sections,

and claimant data

Clearly identify

base data needed

for decision making

purposes

Find orphaned

sections of

legislation, and

identify unused

data items

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Key Differentiator: Multi Lingual capability

Model rules in your native

language in Word or Excel

Model rules in your native

language in Word or Excel

•Easily add new verbs as needed•Easily add new verbs as needed

Integrate natural language

questions into any application

Integrate natural language

questions into any application

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Modernising Social Welfare systems at British Colombia

Requirements

• Provide better integration of services and protection of children

• Deliver a single view of the citizen across services

• Enable visibility into service and productivity

Why Oracle

• Leading policy automation, rules determination and case management

• Proven Enterprise platform that is available commercially off the shelf (COTS)

• Business Insight

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Delivering rapid benefits to Dentists in Sweden

Challenges

• Implement new Dental Reform legislation in tight timescales

• Deliver new Dental benefits calculations and improve Fraud detection

• Complete in parallel with modernisation of Legacy back office systems

Results

• New legislation delivered in four months

• Highly scalable and performant solution

• Success achieved by ‘externalising’ rules from core applications

• Business users built and now own the rules

• Benchmark for future modernisation projects

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Unemployment and related benefits

Overview

• Centrelink is a government agency delivering a range of Commonwealth services to the Australian community.

• Centrelink is set up so people can get the help they need in one place, responsible to Australia’s Department of Human Services

Challenges

• Customer details manually entered from paper form into the mainframe system

• Not user-friendly, with a high level of staff training particularly in mainframe coding

• Repeat visits for the customer with duplication of data collection and process restarts

Business Results

• Reduced training time for new staff

• Significant savings in customer processing times and associated costs

• Reduction in repeat contacts from a customer

• Easier job and business process redesign

• Ability to rapidly extend the system to other payment types

• Consistent service delivery across a greater range of channels

Solution

• Centrelink use Oracle Policy Modeling to capture over 6,000 of their own business policies

• Streamlined customer interviews enable screening and initial data capture for clients using Centrelink offices and call centres

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Kansas Department of Labour (KDOL)

• Initially selected Siebel for use in Call Centres

• Completed successful implementation

• Extended use to Case Management

• Using OPA for weekly certification of all

unemployment benefits

• All eligibility determinations

• All calculations

• Audit trails

• Handling change of circumstances

• Provision of on-line Citizen services

• Replacing modifications in Siebel with OPA

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Oracle Policy Automation:

Live Spanish software demonstration

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Summary: The Policy Automation Difference

• Handling business logic that requires:

• Modelling complex legislation, policy, regulation in a portable

Microsoft Office Document

• Temporal logic or data changes

• Frequent rule changes or updates

• Business rules managed in English or other languages

• While delivering:

• Explanations for how decisions were reached

• Interactive decision guidance

• Compatibility, integration and high performance

• Incomparable rule authoring lifecycle productivity

• Strong testing and maintainability

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Questions