Medicare Advantage (MA) Operations Division – Operational Design Assessment

To maintain their competitive position, the leadership group of a national Medicare Advantage (MA) health insurance company determined the need to reduce operating expenses, improve customer service levels, and ensure regulatory compliance. The goal was to design and implement a solution to achieve a $17 million expense reduction within an aggressive time period.

The MA Operations Division turned to Advanta Healthcare Partners (Advanta) to conduct an assessment and develop a plan to reduce costs by streamlining processes and more tightly integrating existing information systems with business operations, within an 18-month time period. Advanta defined a new organizational and operational strategy and created a roadmap and tactical plan to achieve this new strategy. The roadmap identified the estimated costs, benefits and a high level work plan for seven key projects.

Working jointly with the MA Operations Division, our efforts resulted in developing a strategy and plan to achieve the targeted benefits identified by the leadership group.