When a major national healthcare payer launched a $15 billion enterprise cost reduction effort, it turned to West Monroe’s cross-disciplinary team to envision new ways of working that would lead to next-level efficiency while maintaining a high-degree of customer satisfaction.
Our projects included:
When cost-reduction efforts include a focus on customer and employee experience, they can achieve transformational improvements in satisfaction and loyalty—positioning the organization to thrive.
When a large national healthcare payer undertook a $15 billion cost reduction initiative, it faced a difficult dilemma: How to reorganize its back-office provider support network to better align with workload while maintaining best-in-class service levels.
But this challenge also posed an opportunity to work smarter and serve better. The healthcare payer teamed up with West Monroe to:
Drawing from deep experience in health plan operations and technology, our cross-disciplinary team knew the solution would be in the details. So we got to work:
Our resource capacity planning solution delivered calculated the required hours and full-time equivalent resources by department, allowing the client to reallocate people in response to work volume changes. Each model is based on predictable—and trackable—service demand drivers like call volume, number of doctors added to the database, and errors requiring research, meaning the healthcare payer could live up to its customer service reputation while reallocating business resources when needed.
A project like this is only meaningful when it translates to real business value. Our collective work delivered:
Responding to feedback from its provider network, the payer needed to overhaul its process for onboarding new providers. Onboarding, which includes activities such as enrollment, credentialing, contracting, orientation, and updates, took up to five times longer than the industry average of 15 to 20 days. This delayed patient care, since some doctors could not see patients until they completed the onboarding process.
Improving provider experience was critical to market differentiation. But it also presented an opportunity to reduce cost by automating manual activity. Together, our organizations got to work making that happen.
Our multidisciplinary team of customer experience, technology, operations excellence, and healthcare experts collaborated to improve provider experience – while also reducing process costs significantly. We did this by:
This project busted the myth that reducing cost and improving experience is an either/or proposition. The payer is realizing tangible gains in both areas:
As the onboarding process continues to shift from 100% manual activity to 80% automated activity, the client adds more self-service options for providers. This makes providers happy, and it allows client staff to focus on higher-value work.
The company expects automation to reduce process costs by 44% over five years. And the benefits will only continue to grow. The company plans to expand this initiative to include ancillary specialists such as physical therapy and behavioral health providers.