DailyKaizen

The organization I work in is unique in today’s healthcare market, because we are one of the few remaining staff model HMO’s.  This means that not only are we the insurance carrier we are also the providers of healthcare.  Further, most of the physicians that provide care for the organization are employees.  This provides us a unique set of opportunities if we are able to capitalize on them sense we have different incentives then other insurers or providers.   Primarily, in order to be effective we need to focus on preventive (proactive) care as opposed to dealing with acute problems (reactive).

I am currently working with a small team that is value stream mapping the entire process of care around a specific type of benefits/services.   Like all healthcare organizations we have complex processes and challenges with linking departments and flow patients, information and products.   Yet, even though we have just begun this data collection process it is energizing how much opportunity there is for us to do amazing things for our patients/members that other organizations cannot do, because they are not organized like we are.   Through Lean thinking I believe we can make this happen.  Our success will be determined by our ability to simplify and align our administrative processes around our core clinical value streams.  People need insurance so that they have access to health care and for no other reason.  Really, there is no value added insurance steps.  The only value added steps are those where people are accessing care, or don’t have to because effective prevention practices have occurred.   Thus as we move forward in our Lean journey we need to find ways to make the insurance part of our business seamless or even invisible to our members to that we can focus our energy on what really maters: keeping people healthy!

Trackback This Post | Subscribe to the comments through RSS Feed