A New England HMO owned partly by a multi-hospital academic medical center and partly by its affiliated PHO had reached a strategic crossroads. Leadership believed the time had come to take the HMO to a new level. However, the organization could not afford the required capital, so it began exploring alternatives, including a sale or partnering with a larger health plan.
SSB participated in the evaluation of the strategic options, and spearheaded the strategic partnering process. Along the way, SSB helped the physician owners (a PHO) understand the strategic options and the financial implications, and helped to forge a consensus among physicians concerning the appropriate strategic direction. Through the process, the organization selected one of the health plans in the region that met the criteria that SSB helped define and that demonstrated a cultural fit.
A large national health plan found increasingly that its existing IT capabilities were falling short of the robust solutions needed to offer consumer-driven health plans.
The plan retained SSB to evaluate a range of options for re-shaping its IT infrastructure to accommodate anticipated growth in consumer-focused benefit plans. Potential strategies for moving forward included development and installation of new applications, outsourcing selected IT functions and key business processes, or acquiring appropriate CDHP technology through acquisition or partnership. Working collaboratively with corporate staff , SSB pulled evaluated competitior strategies, assessed selected application vendors and potential strategic partners.
A large, multi-state health plan with over three million members had lost its strategic focus and competitive edge after years of robust growth. This fact was evident from a growing number of performance issues in key business units and minimal emphasis on strategic planning and innovation.
SSB worked extensively with the plan’s board and senior management team to reinvogirate the firm’s historic strength in key product lines, deploy innovative IT solutions for employers and members and re-position the firm as a respected, consumer-focused leader in the health plan sector. Based in large part on the impact of SSB’s efforts, the company has enjoyed significant growth in recent years and its stock is now at an all-time high.
Two mid-Atlantic HMOs were in the process of exploring a very complex merger. The parties had been talking for months, but could not reach a decision. SSB was asked to orchestrate a process that would lead to a decision, one way or another. SSB worked with executives and Board members from both organizations to define the issues, barriers and opportunities associated with the possible merger. SSB also engineered and facilitated a process aimed at resolving a long list of issues as a prerequisite to the parties entering into a Letter of Intent. One key dimension of the project was the development of a strategy to create a joint venture between the merged HMO and the physicians that would lead to tighter affiliation and integration of physician and payor interests. Ultimately, the parties decided not to go forward with the merger, in part because one of the HMOs was owned by multiple competing hospitals and they could not agree on direction.
