Business and IT Transformation Success Stories
Challenge
The payer was losing money rapidly, and the primary contributing factors were unclear.
Solution
An in-depth evaluation revealed that team members were working on over 180 activities that were fast to implement and low-cost but yielded low returns. Leadership collaborated to review and prioritize the top 10 high-impact activities, focusing on those with higher costs but significantly greater returns. Low-return activities were placed in a backlog and could only be addressed once a top-priority initiative was successfully completed.
Benefit
This strategic shift led to the turnaround of a failing claims processing operation, transforming it into an efficient and lean team capable of running at a profit.
Challenge
Fragmented and inefficient claims processing due to multiple decentralized systems and inconsistent regional processes, leading to operational inefficiencies and increased costs.
Solution
Designed and implemented a National Claims Processing application to unify disparate regional systems into a single, streamlined platform. Facilitated collaboration across regions to align workflows, ensuring a smooth transition to standardized processes. Established consistent, well-documented procedures to drive efficiency and scalability.
Benefit
Successfully centralized claims processing, resulting in streamlined operations, enhanced accuracy, and cost savings in the hundreds of millions of dollars.
Challenge
A leading healthcare organization faced inefficiencies due to multiple overlapping systems—GE Health Systems, Allscripts, and a homegrown application. These redundancies stemmed from rapid growth through multiple acquisitions without a centralized IT function, leading to process inefficiencies, manual data entry, and fragmented workflows across the enterprise. The client needed a streamlined approach to optimize system utilization, reduce waste, and improve operational efficiency by leveraging each application for its core strengths.
Solution
We executed a strategic application rationalization and process optimization initiative, which included:
• Application Streamlining & Optimization
• Process Standardization & Automation
• API Development & Integration
Benefit
• Enhanced Operational Efficiency – Reduced manual work and optimized system utilization.
• Improved Data Accuracy & Integrity – Automated integrations minimized errors and inconsistencies.
• Cost Savings – Lowered IT maintenance costs by reducing system redundancy and streamlining licensing.
• Standardized Business Processes – Enabled a unified approach across the entire company for consistency and scalability.
• Increased Productivity – Freed up staff time by leveraging automation and removing inefficiencies.
