Case Study
Transformational Integrated Financing and Delivery Model
Physician Enterprise Transformation
A national integrated payer-provider system with $90B+ in revenue and 20,000+ physicians grew across seven markets ultimately leading to a fragmented Medical Group, Physician Enterprise and payer system.
Opportunities remain to unify the Medical Groups under a new Foundation Model while consolidating, standardizing, innovating, and achieving economies
of scale.
CHALLENGES
Lack of transparency regarding people, processes, and
technologies across the system inhibit progress to drive current state assessment, GAP analysis, and future state design.
Organizational design needs refinement based on the optimal model versus the current structure impacted by culture.
Conducted due diligence and detailed contract design activities in order to inform high-level Foundation Model approach.
Key components of work included Operating Model Design, Legal Contracting, Defining Foundation
Services, Culture, and Change Management.
Successfully navigated overall project, resulting in contract signature for multiple Medical Groups as initial members of Foundation Model.
Selected to partner with organization to begin detailed design and implementation activities.
PHYSICIAN ENTERPRISE TRANSFORMATION
Organizational Redesign at a Physician Enterprise