Transform Member and Community Healthcare
Situational Challenge: Independence Blue Cross is a not-for-profit Health Insurance provider to over 8 million consumers. Approximately 82% of every premium dollar is spent on member care and 10.5% on operating expenses. The challenge was to transform service administration and operation for superior member experience, improved health and wellness, at an elevated medical, administrative, and operational value.
Strategy and Action:
What
- Identified and defined the scope of the problem, objective, and timeline.
- Engaged all stakeholders and focused on their needs in alignment with the objectives.
- Identified measures of success.
- Determined current baselines: process, skills, productivity, costs, margins, quality.
Where
- Determined priority areas, initiatives, funding.
- Engaged business partners and developed governance practices.
How
- Developed the strategy and tactical plans.
- Implemented selected initiatives.
- Developed deep customer analytics, determined call reasons, built a mobile engagement platform, root-cause analysis.
- Continuously tracked to plan and measures of success.
- Held quarterly reviews with Executive Leadership.
Results:
- VP of Medical Management: “You helped change our department culture”.
- Reduced corporate tickets from 14,973 to 1983 ~ 43% yearly, reduced operations cost from $15M to $9M ~ 40% .
- Acquired 200K+ customers in year 1 and reduce the call center calls by 14%.
- A jump of the key national metric – Customer Touchpoint Measure – to the 1st quartile.
