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A Major Health Plan Reevaluates its Strategy Amid a Rapidly Changing, Uncertain Market

Background and Challenge

A major health plan was looking to build on its success by expanding the scope of its services and its geographic reach – all within the context of a fundamental and rapid change within the healthcare sector. Cognizant that even a small misstep could have a lasting negative impact on the organization, the executive team selected L.E.K. Consulting to identify, evaluate and prioritize strategic options, and provide the foundation for its go-to-market strategy.

Approach and Recommendations

L.E.K. partnered with the organization’s senior management team to examine their target population’s healthcare needs and analyze the evolution of virtually every aspect of the healthcare value chain. Importantly, L.E.K. also assessed the health plan’s strengths and weaknesses relative to the dynamic competitive landscape, and identified key growth opportunities for the organization. Key work streams, completed in a collaborative and fact-driven manner, were as follows:

  • Created a dynamic yet fact-based view of the future state; focused on ranges of potential outcomes versus pin-point estimates. Put the emphasis on the implications of those cases for the business (i.e. what would we do differently) versus the future states in and of themselves
  • Validated the fundamental attractiveness of the core business in which the client was engaged. Working closely with the management team, L.E.K. created a bottoms-up, market-by-local market review of the core business
  • Assessed the attractiveness and attainability of adjacent businesses. Since healthcare is intrinsically local, and as excellence in one market or line of business does not automatically translate to universal success, L.E.K. evaluated potential expansion opportunities on multiple dimensions

Results

The effort achieved the following:
  • Clarity for the path forward, with a sound and thriving core business
  • Agreement on the multiple clear paths to growth and sustainable market success
  • A shared, focused vision for the management team
  • Specific metrics and observable milestones to help the management team and the board to ensure timely progression towards the strategic objectives