Managed Care Institution in Trouble

A statewide managed care organization with 19 health centers needed to reduce costs and serve patients better. As costs escalated, so did tension between the doctors and insurance directors, anger among patients waiting for care and vendors waiting for reimbursement.
To make improvements in cost and quality, we chartered several multi-disciplinary teams representing doctors, nurses, administrators, and patient advocates. We put together a Steering Committee and a Communications team to mobilize staff in the 19 health centers.

We worked to align the doctors and insurance executives and trained each team to move rapidly through redesign of key processes. We also coached them on how to get through team breakdowns and the loss of momentum.

An important part of the communications work was making a film, “Voices for Change”, in which patients, medical staff and families made a strong case for change.

A Culture team surfaced the unspoken “cultural rules” that drove behavior in the organization and made specific recommendations on how to change it.
Approximately $12 million in costs were reduced, and changes were made to reduce waiting time of patients and vendor reimbursement. The organization began to focus on high impact interventions such as disease management practices to treat the diseases most affecting their members such as heart disease and diabetes. Culturally, the administration of the organization began to address long-held differences that kept the organization in conflict.

 

 

Lisa combines a corner office view of corporate strategy with a unique depth of understanding of the people element required to get the job done. I have seen her take organizations at war with each other and emerge with a passion around a shared vision for uncommon success.

I have engaged her with all my management teams over the years.

Richard Ross
Managing Partner
Stillwater Group

 

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