Case Study

Automation to reduce costs and improved turnaround time.

Top five health plan and one of the largest providers of Medicare Advantage plans.

         

Industry
Healthcare
Services
Business Process Transformation
Digital Transformation

The Challenge

Like many health plans grappling with the Affordable Care Act’s mandates, our client needed to reengineer their current processes to reduce costs and improve turnaround time. And to do that, they needed wholesale process automation. But to realize automation’s full benefits, the client wanted to work with a vendor offering more than a cookie-cutter, single-issue solution that automated only one area and was based on a transactional payment model. Instead, the client needed a partner. One with the qualified personnel and targeted experience necessary to help identify opportunities for automation, implement solutions across service lines, improve those solutions over time to outpace market forces, and craft contracts that would allow savings to flow directly to the client.

The Sutherland Transformation

Embracing our client’s goal of rethinking the status quo, Sutherland took a broad view of the client’s overall operations. Rather than limiting our strategy to tinkering with the client’s already effective clinical procedures, Sutherland deployed trained personnel across services lines to identify non-clinical automation opportunities. And while other vendors might have hesitated at such a strong and far-reaching partnership—one in which the value of the automation to the client meant potentially hemorrhaging our own revenue.​

While some ‘partnerships’ never go higher than their own bottom lines, Sutherland delivered results even while retaining a pricing structure that allowed 100% of savings to flow directly to the client.​

The Results

Sutherland identified and delivered 17 separate automation solutions, and we continue to find more. Claims, credentialing, and customer support all saw increases in efficiency, errors were reduced, and the savings went directly to the client.​

3,300 manual hours saved annually in claims processing