West Monroe created activity-based resource capacity planning models for the six work groups that support the client’s nationwide network of care providers. The models allow the client to maintain best-in-class support while reallocating resource capacity to meet other business needs.

The Challenge 

Reducing cost while maintaining  service and quality

As part of a $15 billion enterprise cost-reduction initiative, the client—a large healthcare payer—was tasked with right-sizing its back-office provider support network while maintaining best-in-class service levels.  
The client sought a solution that would address its dual service and cost mandates by: 
  • Improving associate productivity 
  • Reducing excess labor spend 
  • Freeing up labor capacity to meet other needs, including growth initiatives

The Solution 

Resource capacity planning models based on detailed work analysis

Applying deep health plan operations experience alongside workforce analysis expertise, the West Monroe team partnered with the client to create a resource capacity planning solution based on predictable and trackable service demand drivers. 

West Monroe led a series of workshop sessions with stakeholders from each group to document responsibilities, map workflows, and define activity task listings for each role. The team conducted 500+ hours of job shadowing and process measurement to determine statistically representative estimated times for tasks. Because most employees worked remotely, the team leveraged collaboration and videoconferencing technology to complete virtual job shadowing. 

Using data analytics, the team identified the critical attributes required to accurately forecast staffing demands. West Monroe used statistical analysis on task-level data to determine high-impact activities and define performance expectations for activities within job functions. West Monroe then created resource capacity planning models for the six groups that allow the client to maintain and modify inputs as business needs dictate. 

Additionally, during the engagement, over 100 process improvement opportunities were identified and documented. 

Finally, West Monroe trained the client’s workforce analytics team on how to use the capacity models and provide support during results communication, implementation, and operational adoption through small focus groups, town hall meetings, and QA sessions with leadership and staff.

The Impact 

Annual benefit of up to $8 million through productivity and process improvement 

Implementation of the new staffing plans determined by resource capacity models will result in a 20% reduction in labor costs—estimated to be ~$5 million. This cost reduction will allow the client to repurpose excess resource capacity and deploy to other areas of their business. 

Additionally, implementing the identified process improvement opportunities—including streamlining operations, utilizing robotic process automation, and reducing the amount of time allocated to non-direct provider support (internal meetings, training, special projects, team touchbases, email, etc.)—will produce additional cost savings of ~$3 million.

Altogether, capacity models and process improvements could deliver an annual benefit of up to $8 million.

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