Using Lean to Optimize Healthcare Insurance

Passing the Affordable Care Act was a big step for Congress. It was a larger step for states to create systems to implement the Act for their constituents.

Our challenge was state-wide for Pennsylvania to bring to individuals and Medicare participants product offerings to meet the changes mandated in the Affordable Care Act. Working with the major Blue Cross Blue Shield provider we implemented the processes and e-commerce system to support a smooth transition and access to products for thousands of participants. Another challenge was how to provide access to sign-ups without being able to hire thousands of people to handle the workload.

The work required recognition of gaps between current and future states, identifying actions and executing kaizen, and rapid defect-free implementation of processes to protect the people of Pennsylvania and to prevent anyone from going uninsured. We convened several subteams and met regularly with core leadership from the company and the State to ensure compliance. We developed multiple systems to enable electronic enrollment including kiosks and online capabilities.

We completed our work within 6 months which was ahead of schedule to enable the State to provide for its people.  The system had a flawless launch for over 10,000 people.