In order to reduce operating costs and improve customer satisfaction levels, a large integrated national health insurance company made the decision to try to simplify and standardize their operating processes and workflows across the multiple sites of their national behavioral health business. The organizational transformation included migrating to a common information systems and technology platform and redesigning processes and procedures to establish a consistent national standard.
Historically, the behavioral health business has grown as a result of the acquisition of multiple regional-based plans. Their expansive core network is a competitive advantage as it offers convenient access to multiple levels of care for all members. However, as they acquired these regional-based plans, they did not integrate them into the new entity. This resulted in a highly matrixed and distributed delivery model with inconsistent capabilities and service delivery across multiple disparate platforms. This increased complexity and inconsistent communication for providers and members who contacted the various locations of the business and decreased provider and member satisfaction.