The Business Challenge

With a large portfolio of commercial and Medicare plan inactive, or low involvement, members and new healthcare innovators moving into the region, this plan needed to increase existing member engagement and step up innovation efforts to compete in an increasingly dynamic marketplace.

A “North Star” Value Proposition in Pursuit of an Ideal Customer Experience

Starting with a wealth of already completed customer research, Aveus began working with the company senior leaders, led by the Chief Operating Officer, in evaluating and mapping the ideal customer experience across their various commercial and Medicare/Medicaid plans. Analysis focused on a large percentage of their consumer member base that had little or no engagement with the plan, creating portfolio churn risks. Contrasting what was happening for members with ideally what should happen for them led the company to a “North Star” value proposition. Using this new value proposition ignited possibilities in pursuit of the ideal. Changes needed at critical moments created wonderful opportunities to strengthen the core business and established a clear need for more innovation.

Igniting Innovation

Through a design thinking process, it quickly became apparent that many of the market changing and growth ideas would not succeed if executed within the framework of the current health plan operating model. A separate agenda of priority innovation projects was established and a “Newco” framework along with resource and capability requirements was constructed and implemented.

Evaluating Change Readiness Before Planning

For an organization that was very financially successful, but uncomfortable with broad change concepts and understanding the risks of a rapidly changing marketplace, it became important to evaluate change readiness. Through an assessment, Aveus helped leaders understand strengths that could be applied to innovation efforts and where gaps existed that needed to be addressed. A roadmap for implementation of both core and Newco prioritized projects was created, accounting for the specific findings from the readiness assessment.

The results?

Teams were created to execute priority initiatives in the core business and a “Newco” division was established incorporating several new hires with outside healthcare experience. The plan continues to thrive and several years later, leaders there say the “North Star” created through this work still guides their innovation efforts and market success.

Additional Benefits Realized

The COO reflected that the Aveus approach to this work taught their team a great deal about disciplines to ensure on-time, whatever-it-takes engagement of all the people on teams to own the work and, importantly, to get the best thinking into the process.

Engagement Timeline (10 Months)

The Aveus engagement changed the ‘pH’ value in our culture. From the journey mapping to the innovation work, we started thinking differently. Second, the value proposition you helped us discover is still our ‘north star.’ It informs our priorities and trajectory.

Chief Operating Officer

Northeastern US 3 Million Member Health Plan