Practice Area: Business-use Programs

Advances in decision support technology frequently outpace a health plan’s ability to organize its operations and business process around the depth of features available in the tools. We have worked across many health plans and have a unique vantage point, having seen tools put into action across a variety of settings.

What is a business-use program?

A business-use program is a structured and formalized initiative that a health plan uses to ensure that high levels of business value are achieved from business processes and the technology tools that support them.

Health plans that are the most successful in capitalizing on their decision support tools have rallied around what the solution provides and have developed formal programs that provide a clear and structured approach to delivering measurable outcomes.

Think of a business-use program as the recipe that you create to produce expected results. A successful recipe requires the right blend of ingredients added at the appropriate time.

How is this an industry challenge?

It is common for health plans to find themselves unable to produce business programs (and their value) organically. This is an industry problem that is very real but not frequently discussed outside of the health plan. After working with many plans, we find that there are common barriers to success, such as:

  • Unclear expectations from leadership regarding how the technology is expected to be used to achieve the health plan’s business objectives and how to measure goal attainment;
  • Difficulties in moving a high-level vision to a concrete structure that has an operational workflow;
  • Staff turn-over;
  • Senior leadership or strategy changes;
  • Department silos that inhibit enterprise-wide business process;
  • Lack of user adoption which limits team members from taking advantage of the depth of what the solution offers.

What is this consulting service?

Grow Forward assists health plans to implement clear, structured and documented business programs that drive success.

Rather than providing unstructured consulting at an hourly charge, Business-use Program engagements are designed to have a beginning and an end. Our efforts begin with an assessment and recommendations. We proceed with developmental stages that have a discreet ending point where the health plan is able to operate independently.

What does this provide?

Our engagements work to strategically aim the technology solution, your health plan team member competencies and your business processes at your goals. Activities to achieve this may include one or more of the following:

  • Assessment of your current use of tools and your barriers to success;
  • Assistance in moving your high-level vision into structured business process;
  • Strategy and execution on plans to overcome your barriers;
  • Assistance with system integrations between decision support tools and care management systems;
  • Assistance in crossing business department boundaries (including IS) to create mutually agreeable business programs;
  • Partnering with you to develop program evaluation metrics and the processes required to harvest and report on the metrics;
  • Expertise in providing customized training to support your business program;
  • Assistance in documenting the business program for consistency and continuity over time.