Home Insights Launching a level-funded health plan quickly and successfully

Launching a level-funded health plan quickly and successfully

The challenge

With health insurance costs rising, employers across the US are seeking more affordable ways to provide high-quality health insurance for their employees.

In the wake of the market trend toward self-insurance, level-funded health plans are a relatively new and increasingly popular offering. This arrangement allows smaller employers to spread the cost of their premiums evenly over the year with fixed monthly claims costs and the opportunity to reconcile at the end of the plan year. The product allows employers to balance risk while keeping health care costs down and incentivizes employers to promote health and wellness for their employees.

Our client, a national health plan with a regional subsidiary, faced a situation in one state where its key competitors either had an existing level-funded offering or had plans to launch one in the near future. Competitors were starting to attract the most desirable “good-risk” customers in the market, which, if left unchallenged, could leave the client with a higher risk membership and rising costs.

The client had limited time to bring a competitive level-funded plan to market and required support to lead and launch this large-scale, highly regulated product.

The approach

With experience leading cross-functional transformational projects, a firm grasp on health plan market trends, and a deep understanding of the client based on previous successful projects, Vynamic was asked to provide the strategic, structured support the client needed.

Our work took the following approach:

Assessing the current state

Because of the scale of the project and the short time-to-market, we needed to quickly establish the minimal viable product the client could launch with and determine how to deliver that in the shortest possible time – all the while ensuring regulatory compliance. We began by carrying out a thorough review of the client’s operating model, processes, and documentation, working with every level of the organization to identify gaps and potential obstacles.

Creating a strategic project plan & defined ownership model

Based on this understanding, we developed a roadmap that balanced both rapid launch and sustained operational excellence, identifying key goals that would quickly deliver the most impact. We also created a clearly defined ownership model identifying stakeholders, responsibilities, objectives, and timelines. This structure ensured teams understood their roles and established accountability for acting in the given timeframe. We also introduced key metrics and project status reporting to ensure teams were delivering as required and quickly escalating issues as they were identified.

Establishing a pilot program & test-and-learn mindset

The client was leaning toward a ‘big bang’ launch, but we ultimately aligned on an approach to launch a pilot program in a controlled environment for the first few months to test, learn, and optimize prior to the broader launch.

This proved to be the right approach and enabled the client to test and refine the product, understand the customer perspective, and gain valuable feedback to inform improvements to the product offering, internal processes, team training, and sales enablement materials. It also ensured that the client had the operational resources and support in place once the program rolled out fully.

The result

The pilot was a success, enabling the team to iron out kinks, accurately position the product, and improve it for the full-scale launch a few months later.

Thanks to Vynamic’s work, the client was able to go to market on time, exceed sales targets, and outperform key competitors. Internally, teams have established a continuous improvement mindset and there has been a cultural shift in terms of future product development and execution. This program is now seen as a blueprint for launching a product through the successful creation and implementation of a Go-To-Market Strategy.

Most importantly, the company has regained the ground it was losing to competitors and has avoided the significant revenue losses it was facing.

About Vynamic

Vynamic, an Inizio Advisory company, is a leading management consulting partner to global health organizations across Life Sciences, Health Services, and Health Technology. Founded and headquartered in Philadelphia, Vynamic has offices in Boston, Durham NC, New York, and London. Our purpose is simple: We believe there is a better way. We are passionate about shaping the future of health, and for more than 20 years we’ve helped clients transform by connecting strategy to action.

Through a structured, yet flexible delivery model, our accomplished leaders work as an extension of client teams, enabling growth, performance, and culture. Vynamic has been recognized by organizations like Great Place to Work and Business Culture Awards for being leaders and innovators in consulting, company culture, and health. Visit Vynamic.com to discover how we can help transform your
organization or your career.

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