Problem
A Fortune 200 company and one of the largest health insurers in the U.S., this successful corporation enjoyed a strong presence in the low growth, government market for health care insurance. A visionary CEO imagined a revolutionary value proposition that would put more accountability in the hands of consumers, thereby forcing the user of health services to exercise more judgment and responsibility in their selection of appropriate services. This transformational strategy required dramatic shifts in the organization’s business model: from a traditional focus on government business to the competitive commercial market; from a customer orientation on corporate employers to a consumer focus on the user experience; from a technologically challenged organization to a dynamic 21st century company poised to deliver real value to end users.

Approach
The CEO chartered a small initial engagement to identify challenges to moving faster. After interviewing his executive team and the next level of senior managers, we concluded that the pace of change was constrained by three issues: 1) lack of executive alignment on a path forward; 2) the organization was tuned to serving corporate clients and the government, and lacked critical understanding of the end user consumer; and
3) the transformation would cost hundreds of millions of dollars. Our team worked with the CEO and Executive Leadership for six months, structuring and facilitating six workshops to redesign the business model to accommodate a new strategic thrust in consumer based health plans. We identified the five strategic imperatives required for market leadership and translated intentions into an integrated roadmap for action.

Results
Recommendations generated broad programmatic actions in the design of the service offering, improved employee engagement, new organizational capabilities, streamlined consumer oriented processes, and an outward looking corporate culture. The organization implemented specific efforts to:

• Redesign the governance process to increase emphasis on strategic direction in addition to operating capability
• Emphasize the small business and individual health care segments by focusing on consumers’ needs for meaningful guidance and flexible health insurance products
• Build consultative sales force competency to prioritize and penetrate new accounts
• Centralize technology and other enabling functions into a shared service infrastructure with economies of scale
• Reengineer operating processes to realize significant improvements in service quality and profitability
• Achieve $500mm in cost savings

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