Two companies, 18 months, no sanctions.
After a major merger, a pharmacy benefit manager had 18 months to bring its clients and members onto one platform without disrupting service. Digineer set up the claims integration PMO, ran the primary IT command center and managed the migration of 10 million Medicare and Medicaid members. It was completed without regulatory sanctions.
At a glance
- Client
- A pharmacy benefit manager, post-merger
- Program
- Post-merger claims services integration and government-program member migration
- Scale
- $400 million of IT work; 10 million Medicare and Medicaid members
- Engagement
- Program management, PMO and command center leadership, 2012 to 2014
- Capability
- Transformation & Value Management
The situation
A merger on a hard deadline
The company set a target of integrating its clients and members into one organization by January 1, 2014, just 18 months after the merger was approved. It had to happen without disrupting service. Missing the deadline would raise operating costs and cut into savings for clients and members.
A merger is also an opening for competitors promising better options, and for clients who might threaten to leave to win better terms. Inside, people who had been competitors now had to work together, and combining companies usually takes longer than expected.
Warning signs
- An 18-month deadline to integrate
- No room for service disruption
- Regulatory exposure on government programs
- Former competitors on one team
- Clients weighing whether to stay
What we did
Accountability, measured
Digineer set up a metrics-based accountability model to keep its outcomes fully aligned with the client’s, and a co-located client results team to support delivery. Then it laid out a plan for delivery, risk, issue escalation, change and communication across the claims services migration.
A claims integration PMO
Digineer established the claims integration PMO, which governed 60% of the IT work, or $400 million, as claims services moved from one legacy platform to the platform the company adopted.
Government programs, protected
Digineer managed the migration of 10 million Medicare and Medicaid members, who account for about $12 billion in annual revenue, alongside a readiness offering for government programs.
The command center
Digineer took control of the primary IT command center to triage, fix and implement post-go-live issues.
The outcome
Integrated, on the client’s terms
No sanctions
The migration of 10 million government-program members was completed without CMS sanctions.
Faster fixes after go-live
Average command center turnaround fell from 5 to 7 business days to 3 to 4.
Savings on delivery
Accountability for several workstreams shortened the delivery lifecycle, saving about $1 million on a $37 million program.
More accurate budgets
Digineer programs ran at 96% budget accuracy, compared with 90% for programs Digineer did not run.
Program management
Facing an integration deadline you cannot miss?
Digineer brings measured accountability, disciplined governance and a steady hand when two organizations have to become one.
Client name withheld for confidentiality.