It didn't take long for HIP to see a return on its investments. After drawing $60 million from the company's reserve fund -- half its value -- HIP paid back the debt in only 18 months. The company's projected revenue from insurance premiums for this year is $2.8 billion. Enrollment is on the upswing; the company covers more than 1 million people in the New York area.

HIP executives credit the turnaround to the merger of good leadership and IT savvy. "The reason why so much has happened successfully, and why it's been embraced by the company, is the absolute link between the business side of this organization and the technology side," McGowan says. "If I hold a meeting and someone from IT isn't present, everybody complains. It's not complete unless you have that perspective."

HIP's IT department has only 244 people, not much compared with some of the largest companies among the InformationWeek 500. But ask Pedro Villalba, senior VP of IT and chief technology officer, how many IT employees he has, and he answers 2,800 -- HIP's total number of employees. "I use all 2,800 people to help me see what's ahead of the curve, what we need to do day today from an operational perspective," Villalba says. "We've touched every place in the organization with technology. We've tried to get everyone involved."

An innovative customer-satisfaction system, on which HIP holds a copyright, is a key element of that effort. The Satisfaction Assurance Workflow System (Saws) is a customer-relationship management platform that links all of HIP's systems and departments, so all employees have access to the same customer data, in real time, using Web browsers. The system uses role-based security, so sensitive data is accessible only to those cleared to see it.

Saws makes everyone in the organization who works a phone line a de facto customer-service rep. "If somebody calls about a letter they received about one of their prescriptions, the customer-service person doesn't say, 'I don't know what you're talking about.' He's got it right in front of him," Villalba says.

Because Saws is browser-based, HIP's business partners can access the data in real time as well. "No matter who looks at our data, they see what we see," says John Steber, HIP's CIO and executive VP of operations. For instance, most hospitals submit claims and are paid electronically. "If they submit a claim and it's not paid, they can access Saws and see why," Steber says.

That efficiency helps explain how HIP, for the past five years, has been able to process 1 million more claims annually. This year, HIP will process 12 million claims. Saws has also helped solve HIP's enrollment problem without expanding customer service.