Cre­at­ing a Shared Sav­ings Prod­uct Solu­tion With a Region­al Health Plan

THE PROBLEM

# Developing Support Structures for Shared Savings Products

A regional health plan was implementing a new shared savings pricing structure for self-insured employers, and they needed a partner to help establish a program dedicated to managing the conversion of all their products within this pricing structure. This process included developing new support structures, such as business logic to define products under the new pricing structure, creating a new claims calculator and billing systems for these products, making changes to contract language to accommodate the new pricing structure, developing a reporting system to track and display accrued savings, as well as creating training, sales support, and communications materials to explain the new pricing structure product portfolio for internal and external audiences.

OUR APPROACH

# Strategic Alignment, Infrastructure Monitoring, and Robust Governance

The Propeller team started by collaborating with technical teams to develop the requirements for the different components of the new pricing structure. We also worked with business teams to understand the potential impact of the solution. After that, the executive team was consulted to ensure that the implementation plans were in line with the organization's strategic direction. We also worked with the client PMO to set up the infrastructure for monitoring project progress. Finally, we created a project governance structure that included workstreams for key milestones, designated leads for each workstream, sponsors to support decision-making and mitigation, and an executive sponsor forum for reporting status and making decisions.

# Services Provided

• Business & Operating Model Strategy
• Data Integration & Vendor Management
• Facilitation
• Go-to-Market Strategy
• Project Management
• Risk Management
• Team Leadership & Development
• Technology Strategy Roadmaps
• Portfolio Planning and Management
• Product Management

VALUE DELIVERED

# Winning Competitive Bids and Increasing Revenue with New Portfolio

Propeller successfully implemented a portfolio of six new and permanent shared savings product offerings, as well as a data calculator to support the portfolio’s claims processing and billing requirements. The project included 12 major workstreams across 18+ organizational departments and disciplines, with a governance process that involved 30+ team members. Propeller ensured viability and ongoing portfolio expansion by assisting in the onboarding of a program director and analyst. Additionally, Propeller developed a process for ongoing evaluation of future portfolio additions and a repeatable action plan. We accomplished this through the development of a program playbook. The new portfolio proved to be a key differentiator, enabling the client to win a large competitive bid for a coveted prospect. This led to an additional $4M in gained revenue and helped the plan’s customers save money.