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Case Study:   How to use Six Sigma  to Reduce Costs and Improve Business Intelligence and Customer Service   Russell Espos...
Session Overview <ul><li>Introduction to HIP of Greater NY </li></ul><ul><li>Six Sigma Summary </li></ul><ul><li>Six Sigma...
Introduction to HIP of Greater NY <ul><li>New York Regional Health Plan </li></ul><ul><ul><li>One Million members, include...
Six Sigma Summary <ul><li>Six Sigma </li></ul><ul><ul><li>An approach to quality that strives for perfection </li></ul></u...
Six Sigma for the Service Industry <ul><li>Define the primary “ Production Line ” </li></ul><ul><li>Define your “ Widget ”...
Universal Delivery System  (UDS)
UDS and Business Intelligence
Objectives and Outcomes <ul><li>KPI’s for Customer Satisfaction and Loyalty </li></ul><ul><ul><li>Two Indexes and Surveys ...
Objectives and Outcomes <ul><li>Reduced Enrollment Cycle Time </li></ul><ul><li>Reduced Payment Cycle Time </li></ul><ul><...
Six Sigma Dashboard
Six Sigma Cost Savings * forecast  Project Milestone Activity Description Count Savings Projects Completed with  Recommend...
Organizational Issues & Governance <ul><li>Organizational Fear and Assistance </li></ul><ul><ul><li>Departmental “ Apostle...
Questions & Answers
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How to use Six Sigma to Reduce Costs and Improve Business Intelligence and Customer Service

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Transcript of "How to use Six Sigma to Reduce Costs and Improve Business Intelligence and Customer Service"

  1. 1. Case Study: How to use Six Sigma to Reduce Costs and Improve Business Intelligence and Customer Service Russell Esposito Vice President, IT HIP Health Plans of Greater New York March 2005
  2. 2. Session Overview <ul><li>Introduction to HIP of Greater NY </li></ul><ul><li>Six Sigma Summary </li></ul><ul><li>Six Sigma for the Service Industry </li></ul><ul><li>Universal Delivery System (UDS) </li></ul><ul><li>UDS and Business Intelligence </li></ul><ul><li>Objective and Outcomes </li></ul><ul><li>Six Sigma Dashboard </li></ul><ul><li>Six Sigma Cost Savings </li></ul><ul><li>Organizational Issues and Governance </li></ul><ul><li>Questions and Answers </li></ul>
  3. 3. Introduction to HIP of Greater NY <ul><li>New York Regional Health Plan </li></ul><ul><ul><li>One Million members, includes Long Island health plan subsidiary Vytra Health Plans </li></ul></ul><ul><li>Commitment to being a Six Sigma Organization </li></ul><ul><ul><li>Continuous learning organization </li></ul></ul><ul><ul><li>Fact driven using standardized techniques and language </li></ul></ul><ul><ul><li>Root Cause Analysis </li></ul></ul><ul><li>Operationally Successful (Pilot Claims Subset) </li></ul><ul><ul><li>95% of claims processed within 15 days </li></ul></ul><ul><ul><li>Top 10% of HEDIS/CAHPs survey for customer satisfaction </li></ul></ul><ul><ul><li>Auto Adjudication rate of 60% </li></ul></ul>
  4. 4. Six Sigma Summary <ul><li>Six Sigma </li></ul><ul><ul><li>An approach to quality that strives for perfection </li></ul></ul><ul><ul><li>Increases efficiency by reducing variability, defects and re-work </li></ul></ul><ul><ul><li>Fundamentals </li></ul></ul><ul><ul><ul><li>Enterprise-Wide effort with common language and tools </li></ul></ul></ul><ul><ul><ul><li>DMAIC (Define, Measure, Analyze, Improve and Control) </li></ul></ul></ul><ul><ul><ul><li>Root Cause Analysis </li></ul></ul></ul><ul><ul><ul><li>Pareto Analysis (80/20) </li></ul></ul></ul><ul><ul><ul><li>Fishbone </li></ul></ul></ul><ul><ul><ul><li>Swim Lanes </li></ul></ul></ul><ul><ul><ul><li>Z-Score </li></ul></ul></ul><ul><ul><ul><li>Cycle Time and Quality Analysis </li></ul></ul></ul><ul><ul><ul><li>Rolled Throughput and the “Hidden Factory” </li></ul></ul></ul><ul><li>If you can’t measure it, you can’t manage it </li></ul><ul><ul><li>Action Workout </li></ul></ul>
  5. 5. Six Sigma for the Service Industry <ul><li>Define the primary “ Production Line ” </li></ul><ul><li>Define your “ Widget ” </li></ul><ul><li>Universal Delivery System (UDS) became HIP’s foundation for Six Sigma </li></ul><ul><li>Defects are measured for each sub-function and Rolled Throughput is measured for UDS. </li></ul>
  6. 6. Universal Delivery System (UDS)
  7. 7. UDS and Business Intelligence
  8. 8. Objectives and Outcomes <ul><li>KPI’s for Customer Satisfaction and Loyalty </li></ul><ul><ul><li>Two Indexes and Surveys </li></ul></ul><ul><li>Merge Survey Indexes and CRM info with Enterprise Data Warehouse Utilization – Enriched Information </li></ul><ul><li>Identify Internal and External (Provider Network) Problems </li></ul><ul><li>Remediate, Re-Measure and “ Hold the Gain ” </li></ul>
  9. 9. Objectives and Outcomes <ul><li>Reduced Enrollment Cycle Time </li></ul><ul><li>Reduced Payment Cycle Time </li></ul><ul><li>Reduced Provider Set-Up Errors </li></ul><ul><li>Reduced Non Scanable Paper Claims </li></ul><ul><li>Increased Claims Accuracy </li></ul><ul><li>Increased Customer Service and Loyalty Indexes </li></ul>
  10. 10. Six Sigma Dashboard
  11. 11. Six Sigma Cost Savings * forecast Project Milestone Activity Description Count Savings Projects Completed with Recommended Changes Implemented 11 $11,798,000 Projects Completed with Recommended Changes Pending 13 $2,600,000* Projects Actively Underway within the Six Sigma DMAIC phases 19 $5,600,000* Projects Currently Being Defined and Scoped for DMAIC 8 - Project Ideas Currently in the Pipeline but not Prioritized or Scoped 23 - TOTAL 74 $19,998,000
  12. 12. Organizational Issues & Governance <ul><li>Organizational Fear and Assistance </li></ul><ul><ul><li>Departmental “ Apostles ” and Presentation </li></ul></ul><ul><ul><li>Bonus Awards </li></ul></ul><ul><ul><li>Educational NOT Punitive </li></ul></ul><ul><li>Governance </li></ul><ul><ul><li>Quality, I.T. and Finance Division Heads </li></ul></ul><ul><li>Drivers </li></ul><ul><ul><li>Top Down </li></ul></ul><ul><ul><li>Bottom Up </li></ul></ul>
  13. 13. Questions & Answers
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