Improving effectiveness, efficiency, service performance, and future capabilities for healthcare payers
What we do
Optimized administrative-cost spend and greater return on investments
We help plans develop capabilities and deliver superior customer experience while optimizing administrative spend. We also help them identify areas of opportunity within the payer value chain to get a fuller view on where to optimize costs and where to enable funding of other parts of the value chain that need advanced capability.
Digitized operations, with a focus on technology enablement
We help payers fully leverage the opportunities of next-generation tools, analytics, digital penetration, and cognitive automation to improve productivity, quality, and customer experience. Through digital technologies, we deliver faster turnaround times for approvals and claims payments, proactively anticipate member and provider needs to improve stakeholder experience, and streamline care management operations to drive increased healthcare value.
Operating-model strategies, capabilities, and improvement programs
We work with payers to develop specific actions and interventions that address the known gaps in capabilities and processes. Furthermore, we help payers set up governance structures to ensure an execution-focused mind-set and drive accountability. Our transformation playbooks help foster a culture of continuous improvement and an agile mind-set within the organization by helping the workforce gain appropriate skill sets and matching talent to value.
Examples of our work
Process- and organization-redesign program for a payer organization
We designed and launched interventions (for example, automation of claims intake) to improve a payer’s operational performance dramatically and build internal capability. We also helped redesign the organization to support the new operating model, with increased accountability from functional leaders and a continuous-improvement mind-set.
Identification of operational-expense savings through a rapid diagnostic
We launched a rapid diagnostic to identify areas of spend growth across an enterprise and designed interventions worth $310 million in net impact to improve operational performance and customer experience.
Spend evaluation and intervention design for a payer’s procurement organization
We reviewed a payer’s entire procurement spend to identify areas of opportunity, implemented interventions worth $350 million, established regular processes, and built capabilities within the procurement organization to lead further implementation.
Featured experts
Brandon Carrus
Senior PartnerOhio - Cleveland
Works with CEOs and top teams to achieve excellence in clinical and service operations
Sameer Chowdhary
PartnerDallas
Serves healthcare organizations, including payers, integrated-delivery systems, and health systems on topics related to operational...
Patrick Finn
Senior PartnerDetroit
Global coleader and North American leader of McKinsey’s Social Sector, Healthcare, & Public Sector Entities Practice, counseling...
Boris Körs
Senior PartnerMunich
Serves clients across the healthcare, health-insurance, pharmaceutical, medtech-manufacturing, and logistics industries
Prashanth Reddy
Senior PartnerNew Jersey
As a leader in the Healthcare, Private Equity & Principal Investors, and Technology, Media & Telecommunications Practices, serves...