I can’t picture running my operation – and my team driving the outcomes that they do – without the Enlighten toolkit, because it’s so simple and enables succesful transformation.


Operation Manager - National Information Brokerage, Mortgage Services & Training SAI Global

The Australian Government’s new healthcare reforms will see an increased focus on making health insurance more transparent, inclusive and easy for customers to understand. Health insurers are now under increased pressure to drive down administration costs, while improving quality and service. 

At Enlighten, we help you maximise performance and improve customer service in healthcare insurance. We partner with you to improve back and middle-office functions, process claims faster and activate results within a single budget year. 

Healtcare Factsheet

Australia’s ageing population is driving increased demand for health insurance services. At the same time, customers are experiencing a rise in out-of-pocket expenses, with a swing away from private health cover. To help remedy this, the Australian Government has introduced a range of new healthcare reforms to make health insurance more accessible and affordable for customers. Throughout the year, Enlighten has gathered the data from Australia and came up with these healthcare factsheet.

State of play

  • Australia’s public health system is struggling to cope with inadequate funding, increased waiting times and fewer beds.
  • Around half of Australians currently hold private health cover, but the number is reducing.
  • Private health funds paid out a combined total of $21,388 million in benefits in the 12 months to December 2019.
  • A survey of more than 2,000 Australians conducted by found that 15 per cent of people are preparing to cancel their cover. Nearly half (44 per cent) blamed rising premium costs for their decision.
  • A poll conducted by the Medical Technology Association of Australia (MTAA) revealed that 77.9 per cent of Australians believe private health funds are motivated by money and put profits ahead of patients.

In response to demand for more accessible health insurance, Australian insurers are facing imperatives to drive down their administrative costs and improve customer service. Enlighten provides a rapid and efficient way to meet these objectives, well within a single budget year.

The back and middle-office functions of claims processing and member management provide excellent opportunities for much-needed improvements. Enlighten’s transformation program and its supporting SaaS analytics can provide the performance changes you are looking for, without the need to change your current IT systems or resort to disruptive outsourcing.

Over the course of 20 weeks, the program will transform your back-office culture. Your teams will be focused on performance and quality, fuelled by the visibility of performance metrics and analytics that activate results.

Latest Success Stories

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Healthcare insurance for union members

Backlogs and cycle times are a major barrier to quality service. We helped 110,000 member private health insurer reduce these barriers to deliver improved service for members.
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Healthcare insurance

By partnering with a 60,000 member healthcare insurance fund, we helped improve productivity across Member Services, Hospital Services and Claims.
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Pharmacy benefit management

Enlighten helped a fast-growing US provider of pharmacy benefit services standardise processes and improve efficiency to provide the very best care for patients.


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