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Re-engineering The Operating Strategy of a Leading Healthcare Service Provider

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A leading provider of risk-adjustment/HEDIS chart retrieval, coding/abstraction, and analytics faced big declines in margins due to rise of new competitors and reduced demand due to EHR and coding technologies. The company sought to identify a new operating strategy to meet demands and quality level and increase profitability in a changing market.

SSA conducted a market analysis to identify value drivers and core operational capabilities needed to compete. The team mined data touch points of 3.2 million charts and tied to activity time and cost models, creating a high-precision view of cost drivers to test an improvement hypothesis. The insights guided the re-engineered labor model that created dynamic labor pools to match demand and capitalize on labor cost arbitrage. SSA & Company also developed a new set of operating procedures and metrics to manage optimal staffing and increase productivity.

The new strategy resulted in a 66% increase in resource utilization across the production workforce, which yielded a 23% increase in contribution margin and created a sustainable path for profitable production while opening new options for competitive pricing strategies.


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