wellpoint: selecting, managing and deploying metrics

Selecting, Managing and Deploying Metrics to Better Serve our Members

Asis DattaBusiness Change DirectorApril 2012

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Agenda

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About WellPoint

About State Sponsored Business

Performance management prior to implementing ActiveStrategy

Implementation of ActiveStrategy

Role of ASE Consulting

User feedback since implementation

Projects in progress

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Agenda

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About WellPoint







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About WellPoint

WellPoint is one of the nation’s largest health benefits companies, with 34 million members in its affiliated health plans and more than 65 million individuals served through its subsidiaries.

• One in nine Americans receives coverage for their medical care through WellPoint's affiliated plans.

• We offer a broad range of medical and specialty products.

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Select Facts About WellPoint

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• IndianapolisHeadquarters

• To improve the lives of the people we serve and the health of our communitiesMission

• PPOs, HMOs, hybrid services• Specialty products (dental, vision, etc.)• Other services (flexible spending accounts,

COBRA administration, etc.)

Products & Services

• Approximately 37,000 as of 12/31/2010Employees

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Agenda

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About WellPoint







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State Sponsored Business (SSB) is part of WellPoint’s full product solution

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Customer Segment Description

National Accounts National Accounts are generally multi-state employer groups primarily headquartered in a WellPoint service area with 5,000 or more eligible employees, of which at least 5% are located outside of the headquarter state.

Local Group Local Group includes customers with less than 5% of eligible employees located outside of the headquarter state, as well as customers with up to 5,000 eligible employees.

Individual Individual customers under age 65 and their covered dependents.

Seniors Medicare-eligible individual members age 65 and over who have enrolled in Medicare Advantage, a managed care alternative for the Medicare program, or who have purchased Medicare Supplement benefit coverage.

State Sponsored Business (SSB)

Members are beneficiaries of State-sponsored program s including Medicaid and Children’s Health Insurance Programs (C HIP).

Federal Employee Programs

FEP members consist of United States government employees and their dependents within our geographic markets through our participation in the national contract between the Blue Cross Blue Shield Association and the U.S. Office of Personnel Management.

Blue Card BlueCard host members represent enrollees of Blue Cross and/or Blue Shield plans not owned by WellPoint who receive health care services in our BCBSA licensed markets.

Specialty Products WellPoint offers a broad array of specialty products including, behavioral Health, Life, Disability, Dental and Vision, products which provide administrative efficiency and enhanced product value.

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• Partner with various states across the country

• Provide managed care benefits for nearly 1.8 million members

• Built infrastructure to support Medicaid Managed Care programs

• Emphasize the value of regular visits to primary care physicians

• Encourage enrollment in our wellness programs

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Agenda

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About WellPoint


Performance Management prior to implementing Active Strategy





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SSB management reports prior to implementing ActiveStrategy

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Monthly spreadsheet reports distributed;

one month lag

Enterprise reports saved to various SharePoint sites

through the month

Monthly e-mails and meetings of financial

results

Department results shared via e-mails

One on one meetings

Periodic (quarterly, annual) meetings to

review business results

Ad hoc requests for information driven by external requirements

/ urgent situations / research

Key Strategic Initiative details interspersed

throughout

ActiveStrategy provides a coherent structure to pull all this information together, make sense of the connection within and between various metrics

and assess the effectiveness of strategic initiatives on a timely basis.

SILOS &DISCONNECTS

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BEFORE ActiveStrategy :Excerpt of a Monthly Excel Report

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PITFALLS• Manual process• Time consuming• Subject to inconsistency and

inaccuracy

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Agenda

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About WellPoint







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SSB needed a sophisticated performance management system … and needed it fast

• Present a prototype in 6 weeks to business leads.

• Present the system by 3 months to senior management for final authorization.

• Launch at the 6 month mark (June 2011).

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• Centralize key strategic initiatives and data in one place.

• Display key performance indicators with drill down capabilities.

• Provide transparency, encourage collaboration and ensure accountability.

• Display strategic priorities in a concise, measurable format.

• Ensure that efforts are focused and aligned to our vision.

Goals Timing

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Why did we select ActiveStrategy?

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ACTIVESTRATEGY

ConsultingSupport

Function-ality

SoftwareConcept

WellPointApprovedVendor

TechnicalSupport

Cost ofEntry

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How were we able to implement ActiveStrategy in only 6 months?

Jan Feb Mar Apr May Jun

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• Established a Team of Five Associates – SSB, Finance , Care Management

Key Milestone : Completed the ActiveStart Administrator Training

• Built an Excel template to define the scorecard str ucture, objectives, measures and their properties.

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• Developed one state scorecard and three product scor ecards.

• Set objectives and commonly used financial/non-finan cial measures.

• Loaded prior year monthly data.

Key Milestone: Presented prototype, received green l ight to proceed.

Key Milestone: ASE Consulting facilitated developme nt of strategy map.


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• Selected and built core set of measures.

• Built a master scorecard.

• Cloned the master scorecard to create the scorecard hierarchy.

• Linked top level scorecard measures to key business unit strategic objectives.

• Loaded prior year benchmarks and current year targets for performance data.

• Built financial, operational and functional metrics “stoplight” charts.

• Built a demonstration briefing book for monthly “deep dive” meetings.

Key Milestone : Demonstrated system to senior management; received approval.


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Insights at the halfway mark…

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Creating a “Strategy Map” clarified the connection points between our vision, financial objectives, customer focus and wo rk processes.

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We recognized the importance of defining types of m easuresand associated ownership:

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More insights at the halfway mark…

Measure Ownership

Financial Finance and Actuary

Operational Source system reporting groups

Functional Various owners• Membership• Program Administration• Grievance & Appeals• Human Resources• Etc…

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• Requested metrics from each measure group.

• The team determined which measures would make the scorecard and tied the measures to the objectives.

• The master scorecard was reviewed with management before cloning commenced.

• Many measures did not make the scorecards but are critical elements in calculations and department focused stoplight chart reporting.

• We ran into challenges with data availability at the state level but not product level – for consistency we built out the same measures across all scorecards. The goal was also to push for product level detail in the future.

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Selecting measures for scorecards was a collaborati ve process:

More insights at the halfway mark…

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Key Learning Points

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The number of measures per

objective must be limited to a few

critical measures in order to make the

scorecard readable.

Measures not in scorecards can still

be presented via Stoplight Charts.

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How did we handle measure data as the system was built?

Dilemma

• The system was in the process of being built.• Data owners and variance report owners were not trained.

Approach

• Finance team member handled the loading of financial information.

• Majority of operations metrics were handled by one department; we trained the one associate who would own the measures and made that individual responsible for loading the operations data.

• The team accessed/collected the standard pre-implementation reports from functional areas and loaded the information.

• The team entered the variance explanations from standard available reports.

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Key Learning Points

Targeted training to update measures.

Up to date system at go live.

Reduce the barrier to acceptance.

Accelerate the system launch!!

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SSB Implementation of ActiveStrategy: Scorecard Hierarchy

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Top-Level Scorecard

State Level Scorecards

Product Level Scorecards

State Reporting Level Scorecards (Future Development)

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Scorecard structure

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Key Learning Point

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Settling on a core set of measures

enables faster cloning of the required

product level scorecards, state level

scorecards and top level scorecards.

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• Contracted with ASE Consulting to support user roll -out.

• Loaded previous month’s performance data.

• Executed communications plan:• Contact all users to confirm measure and initiative ownership.

• Confirm license cost approvals with all users and their managers.

• Notify users of the kick-off and orientation meeting.

• Activate user licenses.

• Set dates for 3 levels of training: “train the trainers”, end users, and executive users.


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• Trained the trainers.

Key Milestone: Kick Off and Orientation Meeting

• Completed end user training.

• Conducted executive training (navigation, business review process).

• Users are responsible for verifying historical data .

• Users are responsible for loading data each month b y required due date.


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• Additional end user training.

• Development of stop light charts and briefing books.

GO LIVE!!


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Implementation results … by the numbers

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30 Scorecards

14 Objectives per scorecard

4,000 Measures

11 Dashboards

17 Stoplight Charts

3 Briefing Books

102 Users

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Lessons learned for fast deployment

• Strong executive sponsorship

• Dedicated Internal team

• Regular communications

• Clear strategy map

• Core set of agreed upon measures (additional build out of specific functional areas can place after deployment)

• Tasks laid out to meet the target date (ASE Initiative!!)

• Executive support at the kick off and orientation meetings

• End user training and support

• ASE consulting and technical support31

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Agenda

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About WellPoint


Performance Management prior to implementing ActiveStrategy

Implementation of ActiveStrategy in State Sponsored Business


User Feedback

Future Projects

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ASE Consulting expedited our implementation

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• ActiveStart training

• Bouncing ideas and approaches off ASE Consulting

• Resolution of the measures naming convention

• Development of the strategy map

• Mass adjustment to measures and global recalculations

• Adding/changing measure and initiative owners/groups

• Removing unwanted measures and variance reports

• Addition of the Forecast Comparator

• Roll out and Communications

• Executive Training

We faced the dual challenge of learning ActiveStrat egyand implementing the system at the same time

ASE Consultingsupport

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Key Learning Point

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Budget for ASE Consulting and

Technical Support.

It will more than pay for itself in time

saved and speed to deploy.

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Agenda

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About WellPoint







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What users have told us since ActiveStrategy was implemented:

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“The fast turnaround is great! It makes such a diff erence to have results and variance explanations for one month ava ilable by the 15th of the next month.”

“Next, we need proactive weekly measures to better influence monthly results.”

“For the first time I have an easy way to track perf ormance and refer back to historical variance explanations.”

“What else will ActiveStrategy do? … my team has sug gestions about more functions and reports we could really us e.”

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Agenda

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About WellPoint







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Our ultimate goal…

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Utilize data to run our business more

efficiently and effectively, thereby

helping to fulfill WellPoint’s mission:

Improve the lives of the people

we serve and the health of

our communities.

wellpoint: selecting, managing and deploying metrics

Health & Medicine