Naya Advisory Services is proud to announce the successful development and implementation of a new Medicare Advantage health plan for five regional hospitals across the Midwest. Our comprehensive approach integrates business IT consulting services with strategic healthcare consulting to enhance patient care and ensure compliance with Medicare regulations. Throughout this process, we focused on delivering innovative solutions that align with the unique needs of each hospital, ensuring they are well-equipped to navigate the complexities of the Medicare landscape.
Naya Advisory Develops Physician Medicare Plan for 5 Regional Hospitals Across the Midwest
Program Management Office Design
At the forefront of this initiative was the establishment of a dedicated Program Management Office (PMO). This PMO played a pivotal role in overseeing the creation and execution of the new Medicare Advantage plan. By coordinating technical integrations, web development, and regulatory compliance, our program management professionals ensured that the project remained on schedule and within budget. Additionally, our close collaboration with stakeholders facilitated communication and alignment throughout the project, further enhancing its overall effectiveness and success.
End-to-End Capabilities Framework
Our team implemented an end-to-end capabilities framework designed to map critical Medicare Advantage functionalities. This framework identified functional gaps and required enhancements while also establishing a clear pathway for the efficient execution of our initiatives. By focusing on these capabilities, we ensured that the new health plan would successfully meet operational needs and patient expectations. This proactive approach streamlined processes and fostered a culture of continuous improvement within each organization, enhancing overall service delivery.
Architectural Roadmap for Project Success
To streamline the launch of the Medicare Advantage plan, we developed an architectural roadmap that outlined the sequencing and prioritization of projects over a three-year period. This strategic planning allowed for phased implementation, enabling our project management consultants to manage resources effectively and adjust to market demands in real time. By establishing clear milestones and deliverables, the roadmap ensured that each project stayed aligned with the overarching goals of the Medicare Advantage initiative.
Market Analysis and Feasibility Studies
Comprehensive market and competitor analytics reinforced the feasibility of the health plan start-up. Through these analyses, we identified lucrative market opportunities that would enable KHS to achieve a return on investment two years earlier than initial actuarial predictions. This approach informed our strategies and positioned our clients for enduring success in a competitive landscape.
Technology Platform Design and Governance Structure
Our expertise also extended to assessing and developing the Medicare Advantage Health Plan Technology Platform Design and Project Plan. This involved a comprehensive review of a commercial health plan's technology and business needs. Using proprietary tools built over 15+ years, we analyzed 126 distinct business capabilities, resulting in a conceptual architecture integrating 55 vendor partners. This foundational design is critical for the future operations of the health plan.
Partner with Naya Advisory
Naya Advisory Services continues to lead the way in healthcare consulting and business IT solutions. By integrating advanced program management and clinical expertise, we are committed to helping healthcare organizations thrive in an evolving marketplace. Contact us today to learn how we can assist your organization in achieving its goals.