Harvard Pilgrim Health Care

Business Situation

Harvard Pilgrim has been the #1 ranked health plan in the U.S. for the past 3 years in terms in member satisfaction and clinical quality according US News and World Report, “America’s Best Health Plans”.  Maintaining the unique quality experience while faced with the requirement of replacing IT systems that manage member enrollment and provider payments is presenting financial and operating challenges. The magnitude of the investments requires longer range investment planning than an annual budget planning cycle can address and the competitors in HPHC’s market are also ranked among the highest in the U.S.

Outcome

HPHC and Accelare developed a multi-year investment and change roadmap that minimizes the risk to performance by evaluating business capability impacts with multiple scenarios over a three year period. Three market and financial scenarios were created which enabled management flexibility to slow or accelerate change based on financial results of the core businesses. As products are introduced and their market share (with contribution margin) becomes reality, the HPHC leadership continually pours its investments into areas that provide the most return.