Overview:

Process Redesign and Technology Enablement to Create a Cost-Effective and Value-Generating Captive Processing Center for a $1B Provider of Individual and Small Group Healthcare

Business Issue:

With an outsourcing strategy already in motion, this healthcare payer needed to evaluate the cost-effectiveness and overall value of starting and running a captive processing center for IT functions in the near term and considering eventual outsourcing for these functions.

Actions:

• Created a re-usable framework for better decision-making within the organization, specifying fact-based criteria and evaluation rigor
• Evaluated alternatives and identified the captive model that made the most sense for this organization, weighing options including… Build from scratch, Acquisition, Build Operate Transfer, or a Joint Venture
• Evaluated alternatives and identified the geographic location that made the most sense for the captive organization
• Prioritized the initial IT functions for implementation in the captive processing center, and the sequence of remaining functions’ implementation