Business Challenge

Our client is a large publicly operated health plan, working closely with its network of delivery systems to improve the quality of healthcare provided. Our client engaged its county-operated delivery system to improve certain Healthcare Effectiveness Data and Information Set (HEDIS) scores. Kenny & Company was engaged to facilitate the improvement efforts, arbitrate cross-organizational barriers to progress and provide insight on the flow of quality data within and between organizations.

The key issues that faced our client were:

  • Ineffective coordination across many departments at both organizations on streamlining quality improvement efforts.
  • Lack of alignment on the quality measures to target.
  • Confusion over how the data that determines quality was transmitted and received between the two organizations.

Client & Engagement Quick Facts

  • Largest publicly operated health plan in the United States, working with the largest Department of Public Health in California.
  • Over 10 administrative departments across the two organizations involved in quality improvement efforts for 23 free standing and hospital-based ambulatory clinics.
  • Emphasis was placed on quality measures affecting the member auto-assignment algorithm.

Our Solution

We engaged with the cross-organization quality improvement team and identified several barriers to progress. We proceeded with issue remediation, meeting with individuals then sub teams to eliminate barriers. We developed a process map to chart the flow of quality data between the organizations to identify then resolve failure points and to communicate data pathways to those involved with the quality improvement effort. We performed data analytics to identify clinic locations and teams where quality interventions would be most impactful.

Business Benefits

Our client improved its HEDIS scores during the engagement. In addition, our client has an effective clinical quality improvement process and toolset with one of their key delivery systems, to serve as a template with other systems.

About Kenny & Company

Kenny & Company is an independent management consulting firm providing Strategy, Operations and Technology consulting services to our clients. Our management consulting practice, experience and insight also enable us to provide early stage venture capital investments to select startup companies, and through our philanthropic endeavors to give back to our communities.