Transformation of UK healthcare insurance provider
The healthcare system in the UK is undergoing unprecedented change to ensure patients receive the highest standards of healthcare, delivered effectively and efficiently. Within the system, private healthcare has been subject to significant medical cost inflation, resulting in increasing insurance premiums.
A fundamental issue facing the healthcare insurance industry was that neither insurers nor members had any control over referrals, and neither the private hospitals nor doctors had any strong incentive to manage costs and improve quality.
Challenge
One of the UK’s largest private medical insurers asked A.T. Kearney to support a comprehensive review of its relationships with the hospitals and doctors that were its main providers. A comprehensive strategic review showed that the insurer required a new approach – they needed to play a far more active role in managing the quality of care delivered.
Approach
A.T. Kearney helped transform the insurer’s healthcare procurement, provider contracting, and performance management, with the goal of putting in place stronger mechanisms to manage the quality and costs of its providers. The performance management framework covers facilities, patient experience and reported outcomes, patient safety, clinical outcomes, conformance to best practice, and commercial management. Additionally, the team developed and implemented a new registration process for doctors.
To deliver these changes, A.T. Kearney contributed its expertise in organisational redesign, provider management, negotiation strategy, and management of complex stakeholder engagements.
Results
The new strategy was developed to source healthcare by specialty, with plans in place to increase competition and choice. Initial commissioning activities have been successful, including:
- Introducing general and speciality-specific quality and performance metrics
- Assuring patient experience while realising significant cost savings
- Transforming the provider management organisation and developing new capabilities within the insurer’s team
Contact
Jonathan Anscombe, partner and co-lead for the firm’s European pharmaceutical and healthcare practice
contact
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