Innovating a Healthcare Payer: Lessons Learned from Lean Startup Transformation: Outside-In Thinking

Sponsored by: Douglas College

Our problem:

Health insurance providers focus on inside out claim management. The business processes are built around assessment of treatments, approval of procedures and efficiency of operations. The IT systems in place are therefore focused on automating internal processes, reducing touch points and supporting the efficiency of operations. On top of which, most healthcare payer operate legacy antiquated systems.

The prevailing mind set is: the customer is an ID, a number rather than a unique individual with specific needs, especially in time of anxiety when they need the healthcare system the most.

Our customers:

The customers that are interacting with the healthcare inside-out thinking are expecting radically better services and are frustrated with the digital infancy of both the providers and the insurers. They are looking for Amazon/Google/Facebook like experiences yet are receiving mediocre service.


Our Lean Startup Transformation

We asked ourselves – how do we jump start a program where outside in thinking is paramount? How do we offer unparalleled healthcare insurance experiences that rival those industries that have undergone digital disruption? How do we reinvent our business thinking? How do we introduce services rapidly without first engaging in a long IT delivery cycle? Are there methods to weed out bad ideas really fast?

It turns out that there are!

Lean Startup coupled with scaled agile delivery and lean UX offered us a way forward.

We selected 5 best practices that helped us reshape both business and IT thinking:

  • Start with the customer in mind.
  • Define and communicate the mission and vision.
  • Synthesize an integrative operating model.
  • Identify metrics that matter.
  • Pivot or persevere.

In the presentation I’ll share the good the bad and the ugly of what we learned from implementing outside in thinking using lean start guidance to innovate a healthcare payer.

Michael Nir, President Sapir Consulting US, is an enterprise lean-agile expert; known for his passion, creativity and innovation; known for his passion, creativity and innovation. His Masters in Engineering, certification in Project Management and training in Gestalt balance his technical know-how with emotional intelligence. He inspires people and teams to change, experientially and emotionally, while climbing the hill AND reaching the summit. The author of ten books on influence, consumer experience, and Agile project management, Michael delivers practical skills gained from eighteen years of experience leading change at global organizations in diverse industries such as: Intel, Philips Healthcare, United Healthcare, DnB, Volvo, JPMorgan Chase, Citi, Unilever and many others. He is masterful at connecting the dots between human behavior, business systems and work environment to drive highly productive teams and lead individuals to communicate effectively. Michael draws on unique personal experiences that provide him with valuable insight. During college in Israel, he led groups of adolescents on excursions through the desert, observing natural leadership behaviors in team settings. Later, on a hike to Alaska, he had to face down a 250 lb Grizzly Bear – giving him a dramatic taste of what it’s like to influence a powerful and threatening personality using wits alone. Michael was born in Los Angeles and resides in Boston. He travels extensively to Europe and East Asia providing consulting and facilitating training. He understands people, organizations and cultures and is comfortable leading cross-functional and cross-cultural workshops.
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