Background and Challenge

A leading, multi-regional, integrated payer-provider was facing a significant, long-term gap between actual and strategic plan performance. This gap was a result of challenges in the external regulatory environment, as well as the complex and competitive environment where the payer-provider operates. Further, the organization was active in a diverse array of markets, making synchronization of strategic efforts more difficult.

The payer-provider required assistance to close the gap within 36 months. L.E.K. was engaged to assist with this company-wide revenue optimization and cost reduction effort. In particular, we participated in the effort to catalog all financial performance initiatives, identify and validate incremental initiatives, and assess the feasibility, timing, and risks associated with each initiative.

Approach and Recommendations

We collaborated with the internal cost structure improvement assessment team in the valuation of improvement opportunities across the enterprise.

  • Led multi-regional, multi-functional project management office (PMO)
  • Cataloged existing improvement initiatives from throughout the organization
  • Identified and validated incremental improvement opportunities via collaboration with the organization’s staff and leveraging our experience and intellectual property
  • Codified and prioritized initiatives for implementation, including: initiative description, magnitude and timing of financial impact, required investment, risks, and high-level implementation roadmap
  • Prioritized initiatives for implementation

Results

We provided a clearly defined, cohesive set of initiatives representing more than $2 billion of incremental run-rate operating profit improvement opportunities (~6-8% reduction in operating expenses) enabling the organization to close the gap, improve operational performance and achieve its strategic plan objectives.