Creating hospital contracting processes that maximize performance

The challenge

A new parent corporation, created from the merger of two complementary New York Health Plans, took steps to combine the two organizations to yield efficiencies and optimize the strengths of each organization. A new executive was hired and was asked to accelerate the integration within the Healthcare Management division of the organizations. He identified the hospital contracting and implementation functional areas as a priority area for focus.

Our approach

Vynamic conducted a current state assessment of the Health Plan’s hospital contracting and implementation processes and worked with subject matter experts to identify strengths, vulnerabilities and actionable improvement recommendations. These assessment findings were mapped to best practices and desired business outcomes in order to create a future state integrated hospital contracting and implementation process with implementation roadmaps and tools/checklists in support of the process.

The results

Vynamic’s design and development of the enterprise process with timeline and accountabilities led to successful implementation of our customer’s hospital contracting and implementation process.

Some specific benefits achieved include:

• Execution of consistent processes enabling more accurate response to external customers
• A transparent process that encourages a Provider and Plan dialogue and negotiation
• Organizational clarity and alignment of functional areas within Network