Project Portfolio Optimization & Blue Print

© Blue Slate Solutions 2013

2013 BPM Network Annual Summit

October 8, 2013

Project Portfolio Optimization & BluePRINT™


About Blue Slate

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Blue Slate’s strategic focus is to optimize health plan operations We have successfully assessed, planned and implemented

strategic initiatives with over 25 different health plans including: o 3 Medicare Administrative Contractorso 10 BCBS Association Memberso 2 of the 3 largest national health planso Dual eligible health plans

Over the course of these relationships, Blue Slate has completed more than 225 projects within health plan operations

Industry leader in: BPM, including automating workflow and business rules Federating data from a variety of systems for purposes of analytics


What is the problem?

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Healthcare Reform mandates, consumerism, and the need to diversify their business have health plans operating at a heightened level of complexity

Given all of these changes, many of our clients are struggling to define and operationalize their strategy and prioritize projects to meet mandates and achieve their strategic vision

Today we will be focusing on the project prioritization phase, but we will also talk a bit about how to first identify those strategic projects


I don’t know my strategic projects yet! Where do we begin?

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Don’t worry! A good first step is to perform an Operational Assessment!

We’ve helped other health plans, using our BluePRINT methodology, to identify both “quick win” and transformational projects that get to future state paradigms and enable the known and anticipated goals of business


A quick primer on creating your roadmap

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• Define project roles and governance

• Understand high level business strategy, goals, corporate policies and operating model

• Define critical success factors

• Identify constraints

• Project Kick-off

• Conduct Interviews to baseline current processes and systems

• Analyze current state processes for process improvement opportunities

• Review current systems and integration points

• Gather/Document current business rules

• Initiate current state scorecard

• Validate current state findings

• Identify opportunity themes leading to desired change

• Develop quick win projects based on stated business drivers

• Create the high-level future state vision and identify opportunities for improvement to the current state

• Analyze business rules and configuration opportunities for systems

• Validate improvement opportunities and future state vision

• Prepare Optimization BluePRINT that includes recommendations, impact, and preliminary effort estimates for a more integrated and efficient process

• Report-Out the optimization summaries, plans, and business cases in the context of the BluePRINT to drive next actions


Project Deliverables

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Output includes “Quick Win” and Transformational projects that document goals, business value, deliverables, etc.


OK, got the projects set…. Now what?

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Health plans need a way to objectively prioritize any list of projects (or tasks or features or issues or risks, etc.) by comparing them against a set of agreed upon prioritization criteria (aka Business Success Factors)

Using methods, like the Blue Slate Planning and Decision Making System (based on the Six Sigma principle of QFD), businesses can truly find out what they desire as a future state and prioritize the projects that will most effectively get them there

This is not just a tool kit! This is a facilitated process that encourages participation by all parties and provides a framework to obtain consensus amongst the Key Stakeholders


End Goal: “Actual” Prioritization Matrix

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Click here for Overview page

Note:In each open square, enter a rating (H/M/L) to indicating the 'extent' to which the project meets the criteria and/or the business need

H = High - Exceeds the business need/expectations

M = Medium - Meets the need

L = Low - Barely meets or does not meet the need

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Priority Score RANK

q Projects Importance u H H H M H

2 Financial Recovery (Workflow) H L M L 108 216 Training L L L L 30 165 EDI incl IVR and incl legacy 4.2 data (Workflow) L L M L M 75 57 Medical Review and Reopenings (Workflow) M M M L 72 78 Internal Audit - Gen3 (Workflow) M L L M 66 88 Internal Audit - Gen 4 (Workflow) L M L M 66 8

16 Change Management process L L L L 30 168 Contact Center Ph 3 – Written Corr (Workflow) M M L L 66 8

12 Contact Center Ph 3 – Clerical Reopenings (Workflow) L M M L 54 1214 Contact Center Ph 3 – Enhanced Call Flow (IVR) M L L L 48 1412 Outbound Correspondence (incl template standardization) L M M L 54 121 Data Transition L H L L L 111 15 Data Masking M L L L M 75 5

16 System X monitoring and reporting L L L L 30 164 System X infrastructure upgrade L M M L M 93 4

14 Production Maintenance & Support for all Applications (TICKETS) L L L M 48 148 Knowledge Transfer on applications M L L M 66 83 Legacy Data Warehouse (for Contact Center) H L L L 102 3

Prioritization Criteria


So how do we do it?

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Step 1 Develop a list of your Prioritization Criteria (aka the success

factors) This list should initially be at a fairly high level and represent key

business needs that the projects should address “On-board new members faster” “Reduce call volumes” “Reduce caller wait time” “Improve first-pass rates”

Selection criteria should be measurable

CRITERIA

1 CMS/Internal mandate (external drivers, eg. Hardware lease, CR, Steering ctee)

2 Project is greater than 50% complete

3 Increase operational area thru-put (e.g. improved legacy integration)

4 Existing workflow integration (intra-dept. vs. standalone)

5 Return on Investment (Value/cost) - cost avoidance not hiring add'l resources


So how do we do it?

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Step 2 Establish the relative importance for each of the Prioritization

Criteria

Use a simple H/M/L scale

You may hear “they are all important”. Remember, this is their importance relative to each other!

CRITERIARelative Importance

to Business(H / M / L)

1 CMS/Internal mandate (external drivers, eg. Hardware lease, CR, Steering ctee) H

2 Project is greater than 50% complete H

3 Increase operational area thru-put (e.g. improved legacy integration) H

4 Existing workflow integration (intra-dept. vs. standalone) M

5 Return on Investment (Value/cost) - cost avoidance not hiring add'l resources H


So how do we do it?

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Step 3 Select your the list of Projects to prioritize

This should be an output from your BluePRINT or other Operational Assessment. A sample project with suggest data elements is noted on the next page

PROJECTS

1 Financial Recovery (Workflow)

2 Training

3 EDI incl IVR and incl legacy 4.2 data (Workflow)

4 Medical Review and Reopenings (Workflow)


GoalUpdate and socialize the current business strategy with current competitive forces, market opportunity, internal capability etc.

Objectives• Define scope for inclusion in updated strategy • Collect, combine, existing strategies above and below

defined scope. • Create updated E2E strategy • Review and gain consensus for adoption of the updated

Project OSG-1: Project 1

Project Goal and Objectives

Deliverables

Business Value/Benefits

• Resource allocation profile:

• Total Applied Effort (hours): 360-450 hours

• Duration (weeks): 3-4 weeks

• Identifies business industry changes and key external trends

• Indicates future direction, strategy and business model for the business and the industry as a whole

• Secures a common understanding and commitment in complex matrix of functions that make up the business

• Moves the business away from reactive and toward to proactive

• Informs employees, management, vendors and others about the strategies and plans for the organization

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• Strategy Statement

• Industry Analysis and Trends

• Competitive Analysis

• Internal Firm Analysis

Summary Project Plan

Updates Strategy

Resource Name Estimated Effort (hrs)PM 80BA 240

Tech 0BusSME 0ITSME 40

Sample Project Form with Data


So how do we do it?

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Step 4 Looking at only one Criteria (column) at a time, rate the extent to which

each Project meets the Criteria Repeat this step for of the Criteria (Column) This step is where most of the discussion, debate, and consensus

building comes from and whose success, in part, depends on careful, effective facilitation






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Financial Recovery (Workflow) H L M LTraining L L L LEDI incl IVR and incl legacy 4.2 data (Workflow) L L M L MMedical Review and Reopenings (Workflow) M M M L



So how do we do it?

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Step 5 Calculate a “Priority Score” based upon the H/M/L non-linear scale Generally H=9, M=3, and L=1 MULTIPLY how well the project meets the criteria (column) by the

importance (H/ML) of the column… then add across columns to get your “Priority Score”






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Priority Score


Financial Recovery (Workflow) H L M L 108Training L L L L 30EDI incl IVR and incl legacy 4.2 data (Workflow) L L M L M 75Medical Review and Reopenings (Workflow) M M M L 72



So how do we do it?

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Step 6 Rank your projects by Priority Score to provide a view into which

projects will best meet the business objectives/success criteria






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Priority Score RANK


1 Financial Recovery (Workflow) H L M L 108 14 Training L L L L 30 42 EDI incl IVR and incl legacy 4.2 data (Workflow) L L M L M 75 23 Medical Review and Reopenings (Workflow) M M M L 72 3



Complete “Actual” Prioritization Matrix

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We are not done yet! Build a Project Estimate Landscape

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Icon Track Projects Effort(hrs)

Duration(wks)

Organizational Structure and Governance

OSG-1: Project 1OSG-2: Project 2OSG-3: Project 3OSG-4: Project 4

360-450550-690650-800

3050-3800

3-412-1616-2030-34

End-to-End Process Integration

E2E-1: Project AE2E-2: Project BE2E-3: Project C

1100-1375500-690

1060-1325

8-106-8

6-10

Process & System Optimization

PSO-1: Project XPSO-2: Project YPSO-3: Project Z

4250-5300950-1200600-750

28-348-106-8

Service ModelSM-1: Project BlueSM-2: Project Green

700-8751800-2250

12-1620-25

Create Estimates, Rank, and Plot your projects based on business track


You can then add a time scale to the project portfolio

Operational Readiness & BluePRINT™

Project 1: 2Q 2013

Strategic Alignment / E2E Implementation

(Project Set 3: 1Q/2Q 2014)

Remediation PlanImplementation

Rapid, Incremental Changes to Generate Immediate Internal Improvement

Facilitate Best-in-Class Process Improvement

Current

•Vision, Blueprint, •Remediation Evaluation

Audit and Remediation Plan

Product Delivery (Project Set4: 2014)

Near-Term

• E2E-1 Project A• E2E-2:Project B• E2E-3 Project C• PSO-2: Project Y• SM-1: Project Blue

2014 and beyond• OSG-4: Project 4• PSO-3: Project Z• SM-2: Project Green

TransformationalStabilization

Short -Term Now • OSG-1: Project 1• OSG-2: Project 2• OSG-3: Project 3• PSO-1: Project X

Stabilization, Strategy and E2E Start Up

Project Set 2: 3Q/4Q 2013

Best in class organization

Integrated processes

and service


Let’s Review

• Perform and Operational Assessment, such as a BluePRINT

• Determine your projects goals, value, and budget as an input

• Use a QFD based model, such as the Blue Slate Planning and Decision Making System, to prioritize your projects/business objectives

• Build your project landscape• Plot your projects out across a timescale• Call Blue Slate to help!

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Questions?

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David Scholl, Director

[email protected]

Mike Sefransky,Director

[email protected]

mailto:[email protected]



Technology

Project Portfolio Optimization & Blue Print