Modernizing business practices in the post-PHE era through a service-first philosophy

*This article was originally published in Modern Healthcare: Modernizing healthcare business practices in the post-public health emergency era through a service-first philosophy | Modern Healthcare

By: Jessica Stimpson, market lead, public sector programs

In the post-public health emergency (PHE) era, healthcare organizations face a pressing need to modernize business processes. But while we as administrators wrestle with the allure of new technologies to solve our problems, it’s important to recognize there’s more to modernizing than the newest robotics or automation technologies.

A successful business modernization approach is built on equal parts technology, process and people.

Why the race for business process modernization?
Business process modernization (BPM) is not new. As healthcare payers we operate in an environment where efficiency and accuracy reign, so process improvement and streamlining workflows are everyday events. But along came the pandemic that pressure-tested absolutely everything in traditional healthcare.

The industry experienced increased challenges including a surge in demand for flexible healthcare services that exposed the limitations of traditional systems. Organizations went into crisis mode. And many did so admirably, jumping into action to ensure people were able to continue to access healthcare.

However, it was following the pandemic that new challenges arose as state agencies grappled with PHE redeterminations. Many agencies are still dealing with an overwhelming increase in service volumes. The opportunity now is to gather all we’ve learned and use it to drive ongoing BPM efforts.

Post PHE—an opportunity to pause and reevaluate
As we transition into the post-PHE era, payers need to evolve beyond crisis response and proactively build resilient organizations for the future while continuing to leverage the flexibilities offered during the pandemic such as telehealth.

Organizations and individuals want an Amazon-like experience—seamless and hassle-free. So how do we modernize our traditional healthcare business practices to accommodate that expectation?

Noridian Healthcare Solutions is an administrative services company that stands out for not just weathering the pandemic but also going the extra mile in serving both public and private healthcare payers through its BPM efforts. The marketplace is taking note of its holistic nature and providers are seeing improvements in process and culture.

Noridian has agreed to share its successful BPM game plan in hopes of helping others consider their post-PHE modernization plans.

A strategy for post-PHE modernization
What makes Noridian’s model distinct? Most would attribute the company’s pandemic response success to three factors:

  1. Service-first approach: Since its inception, Noridian has taken a service-first approach to BPM, giving equal weight to process and people.
  2. Quick response: The company was already into its BPM journey when the pandemic arrived on scene.
  3. Wholistic nature: Noridian’s BPM efforts extend beyond IT-driven automation; they include constant, widespread daily innovation to reimagine workflows.

BPM processes have grown from a single business unit’s initiative to the company’s operating foundation.

People and process —two sides of the modernization coin

BPM—the process 
Noridian’s BPM model is holistic and multidisciplinary. Where most continuous improvement models incorporate one-off efforts to help identify opportunities for efficiency, Noridian’s brand of BPM examines whole processes and reshapes workflows from beginning to end.

The entire organization has been trained to reimagine processes, empowering employees to overhaul workflows. BPM is no longer something Noridian does, rather it’s who we are as an organization. There’s an expectation that the company will always be changing.

Company-wide collaboration leads to buy-in 
Noridian’s BPM model does away with leadership directives being forced on operational staff. Solutions are formed collaboratively across the company.

The real BPM work starts and ends with operational employees when they’re joined by IT analysts, finance staff and the quality team to examine and imagine different workflows. The multidisciplinary team maps workflows, identifies waste, automates where possible and, ultimately, rolls out new plans.

These project teams serve as a model to encourage collaboration, brainstorming and inspire creative solutions.

BPM—the people 
“Will I have a job?” Consciously or subconsciously, that’s a fear that keeps people from participating in change efforts. It follows, then, that helping people thrive through change requires creating a safe environment.

Leaders are specifically trained to lead their teams through innovation and change management. Part of that training is developing trust around why the company has adopted a continuous innovation business model.

At Noridian, BPM is not about reducing headcount. It’s about maximizing process and giving people more meaningful work, so they add value in new ways, for example:

  • Upskilling call center employees: Noridian took a unique proactive approach to training call center employees. To create empathy with potential callers, the company took call center staff through an extensive poverty simulation experience. That experience fostered a deeper understanding and improved communication with callers facing economic challenges.
  • Provider management as customer success: Noridian views healthcare providers as customers. Recognizing they play a crucial role in supporting interactions with various public and private healthcare programs, Noridian focuses on setting providers up for success. The provider management approach prioritizes customer service and enrollment efficiency, ultimately facilitating improved access for members to leverage their healthcare.

Providing more meaningful work has improved the Noridian employee value proposition. People tend to stay at organizations where they find the work meaningful.

Everyone wins 
It’s a natural inclination for people to resist change, but changing the culture involves helping employees thrive through change. Employees at every level share in the enthusiasm as they see results.

Process engineers get to show others their world as they dissect workflows and introduce modern tools for efficiency, quality monitoring and ongoing continuous improvement.

IT analysts get to bring in newer technologies, like automation and robotics software, and expand existing technologies to other departments.

Operational staff are active participants in the solutions. Ultimately, they’re released from repetitive tasks and can take on more creative thinking and peer collaboration.

At the end of the day, what the customer cares about is that the organization has a culture that delivers great value.

As we navigate the post-PHE era, healthcare programs should prioritize service philosophy modernization alongside technology. It’s our collective opportunity to build a healthcare future that puts people first.

If you are a federal, state or commercial health program who is interested in learning more about how Noridian can help modernize operations, please Contact Us.

About the author
Jessica Stimpson is the public sector market lead at Noridian Healthcare Solutions. Serving as the central contact for state health programs, Stimpson is responsible for bringing the innovative administrative services and renowned customer experience Noridian is known for to new Medicaid markets. As market lead, she manages relationships with key Noridian customers and influencers including executive leadership, external stakeholders, and operating leaders.

Prior to this role, Stimpson worked closely with Noridian for nearly two decades in a customer capacity, most recently as the vice president of sales and marketing at Blue Cross Blue Shield of North Dakota where she set sales and product strategy and focused on providing high quality products services to all customers.