AmeriHealth Caritas: Next generation service delivery model



The challenge

The convergence of a rapidly evolving healthcare landscape, increased focus on regulatory guidelines, and reduction in medical reimbursement levels was dramatically impacting a Medicaid health plan’s ability to meet the changing needs of its membership and drive market performance. To respond to these pressures, the Public Health organization partnered with Vynamic to determine the operational changes and investments that would help them achieve the right balance of resources to achieve their performance goals.

Our approach

Vynamic used a proven approach to assess business functions across the organization. The Vynamic team explored how and where work was performed, mapped the current structure against industry best practices, and created a blueprint for the successful deployment of improvement initiatives that were key to successfully implementing the new service delivery model.

The results

Working closely with our client, Vynamic developed a detailed portfolio of recommendations that, if implemented, will drive dramatic internal efficiency and cost avoidance savings while positioning them for growth.

Some specific results achieved include:

• As assessment of their current operating model, highlighting work effort, handoffs, metrics and potential for improvement
• An understanding of how their current operating environment compares to similar Health Plans
• An immediate opportunity to realign key operating functions to encourage organizational leadership and drive overall growth and performance