A large healthcare solutions organization operates in a perfect storm of high-stakes conditions: As a designated Medicare Administrative Contractor (MAC), all revenues come from a small number of multi-year government contracts. The competition between MACs is fierce, with the pipeline of available contracts shrinking, and every bid a “bet-the-company” effort.
The MAC sector is technology-intensive, using IT-enabled scale and speed to collectively process more than 1.2 billion Medicare claims a year. Our client’s leadership asked KPMG to assess and retool its Information Technology (IT) operations in order to reduce costs-per-claim—the all-important industry benchmark. With KPMG’s help, the healthcare organization is on its way to potentially reducing IT costs by 20 percent and driving costs-per-claim to industry-leading levels. The organization’s leadership has staked its claim in a survival-of-the-fittest future.
With KPMG’s help, our client is now positioned for survival and growth during a period of industry consolidation, when the difference between commercial success and failure rests on a relatively small number of large Medicare contracts. Specific benefits include:
KPMG worked together with our client’s leadership over a two-and-a-half-year period to design and implement a cost-efficiency-focused IT solution. KPMG:
We help different types of stakeholder communities—in this case, end-user government agencies, our client’s parent company, leadership and IT staff, and current or prospective external IT partners—easily understand the challenges and benefits that are relevant to their specific interest.
We’re able to identify the precise drivers of IT cost—broken down by function—and then turn them into tangible savings, with pragmatic solutions that we’ve successfully used in similar engagements or other industries.