Project Portfolio Optimization & Blue Print

© Blue Slate Solutions 2013
2013 BPM Network Annual Summit
October 8, 2013
Project Portfolio Optimization &
BluePRINT™

About Blue Slate
1
 Blue Slate’s strategic focus is to optimize health plan
operations
 We have successfully assessed, planned and implemented
strategic initiatives with over 25 different health plans including:
o 3 Medicare Administrative Contractors
o 10 BCBS Association Members
o 2 of the 3 largest national health plans
o Dual eligible health plans
 Over the course of these relationships, Blue Slate has completed
more than 225 projects within health plan operations
 Industry leader in:
 BPM, including automating workflow and business rules
 Federating data from a variety of systems for purposes of analytics

What is the problem?
2
 Healthcare Reform mandates, consumerism, and the need
to diversify their business have health plans operating at a
heightened level of complexity
 Given all of these changes, many of our clients are
struggling to define and operationalize their strategy and
prioritize projects to meet mandates and achieve their
strategic vision
 Today we will be focusing on
the project prioritization
phase, but we will also talk a
bit about how to first identify
those strategic projects

I don’t know my strategic projects yet! Where do we begin?
3
 Don’t worry! A good first step is to perform an
Operational Assessment!
 We’ve helped other health plans, using our BluePRINT
methodology, to identify both “quick win” and
transformational projects that get to future state
paradigms and enable the known and anticipated goals
of business

A quick primer on creating your roadmap
4
• Define project roles
and governance
• Understand high
level business
strategy, goals,
corporate policies
and operating
model
• Define critical
success factors
• Identify constraints
• Project Kick-off
• Conduct Interviews to
baseline current
processes and
systems
• Analyze current state
processes for process
improvement
opportunities
• Review current
systems and
integration points
• Gather/Document
current business rules
• Initiate current state
scorecard
• Validate current state
findings
• Identify opportunity
themes leading to desired
change
• Develop quick win
projects based on stated
business drivers
• Create the high-level
future state vision and
identify opportunities for
improvement to the
current state
• Analyze business rules
and configuration
opportunities for systems
• Validate improvement
opportunities and future
state vision
• Prepare Optimization
BluePRINT that includes
recommendations,
impact, and preliminary
effort estimates for a
more integrated and
efficient process
• Report-Out the
optimization summaries,
plans, and business
cases in the context of
the BluePRINT to drive
next actions

Project Deliverables
5
 Output includes “Quick Win” and Transformational projects
that document goals, business value, deliverables, etc.

OK, got the projects set…. Now what?
6
 Health plans need a way to objectively prioritize any list
of projects (or tasks or features or issues or risks, etc.) by
comparing them against a set of agreed upon prioritization
criteria (aka Business Success Factors)
 Using methods, like the Blue Slate Planning and
Decision Making System (based on the Six Sigma
principle of QFD), businesses can truly find out what they
desire as a future state and prioritize the projects that will
most effectively get them there
 This is not just a tool kit! This is a facilitated process
that encourages participation by all parties and provides a
framework to obtain consensus amongst the Key
Stakeholders

End Goal: “Actual” Prioritization Matrix
7
Click here for Overview page
Note:
In each open square, enter a rating (H/M/L) to indicating the 'extent' to
which the project meets the criteria and/or the business need
H= High - Exceeds the business need/expectations
M = Medium - Meets the need
L = Low - Barely meets or does not meet the need
CMS/Internalmandate(external
drivers,eg.Hardwarelease,CR,
Steeringctee)
Projectisgreaterthan50%
complete
Increaseoperationalareathru-put
(e.g.improvedlegacyintegration)
Existingworkflowintegration(intra-
dept.vs.standalone)
ReturnonInvestment(Value/cost)-
costavoidancenothiringadd'l
resources
Priority
Score RANK
q Projects Importance u H H H M H
2 Financial Recovery (Workflow) H L M L 108 2
16 Training L L L L 30 16
5 EDI incl IVR and incl legacy 4.2 data (Workflow) L L M L M 75 5
7 Medical Review and Reopenings (Workflow) M M M L 72 7
8 Internal Audit - Gen3 (Workflow) M L L M 66 8
8 Internal Audit - Gen 4 (Workflow) L M L M 66 8
16 Change Management process L L L L 30 16
8 Contact Center Ph 3 – Written Corr (Workflow) M M L L 66 8
12 Contact Center Ph 3 – Clerical Reopenings (Workflow) L M M L 54 12
14 Contact Center Ph 3 – Enhanced Call Flow (IVR) M L L L 48 14
12 Outbound Correspondence (incl template standardization) L M M L 54 12
1 Data Transition L H L L L 111 1
5 Data Masking M L L L M 75 5
16 System X monitoring and reporting L L L L 30 16
4 System X infrastructure upgrade L M M L M 93 4
14 Production Maintenance & Support for all Applications (TICKETS) L L L M 48 14
8 Knowledge Transfer on applications M L L M 66 8
3 Legacy Data Warehouse (for Contact Center) H L L L 102 3
Prioritization Criteria

So how do we do it?
8
Step 1
 Develop a list of your Prioritization Criteria (aka the success
factors)
 This list should initially be at a fairly high level and represent key
business needs that the projects should address
 “On-board new members faster”
 “Reduce call volumes”
 “Reduce caller wait time”
 “Improve first-pass rates”
 Selection criteria should be measurable
CRITERIA
1 CMS/Internal mandate (external drivers, eg. Hardware lease, CR, Steering ctee)
2 Project is greater than 50% complete
3 Increase operational area thru-put (e.g. improved legacy integration)
4 Existing workflow integration (intra-dept. vs. standalone)
5 Return on Investment (Value/cost) - cost avoidance not hiring add'l resources

So how do we do it?
9
Step 2
 Establish the relative importance for each of the Prioritization
Criteria
 Use a simple H/M/L scale
 You may hear “they are all important”. Remember, this is their
importance relative to each other!
CRITERIA
Relative Importance
to Business
(H / M / L)
1 CMS/Internal mandate (external drivers, eg. Hardware lease, CR, Steering ctee) H
2 Project is greater than 50% complete H
3 Increase operational area thru-put (e.g. improved legacy integration) H
4 Existing workflow integration (intra-dept. vs. standalone) M
5 Return on Investment (Value/cost) - cost avoidance not hiring add'l resources H

So how do we do it?
10
Step 3
 Select your the list of Projects to prioritize
 This should be an output from your BluePRINT or other Operational
Assessment. A sample project with suggest data elements is noted on
the next page
PROJECTS
1 Financial Recovery (Workflow)
2 Training
3 EDI incl IVR and incl legacy 4.2 data (Workflow)
4 Medical Review and Reopenings (Workflow)

Goal
Update and socialize the current business strategy with
current competitive forces, market opportunity, internal
capability etc.
Objectives
• Define scope for inclusion in updated strategy
• Collect, combine, existing strategies above and below
defined scope.
• Create updated E2E strategy
• Review and gain consensus for adoption of the updated
Project OSG-1: Project 1
Project Goal and Objectives
Deliverables
Business Value/Benefits
• Resource allocation profile:
• Total Applied Effort (hours): 360-450 hours
• Duration (weeks): 3-4 weeks
• Identifies business industry changes and key external trends
• Indicates future direction, strategy and business model for
the business and the industry as a whole
• Secures a common understanding and commitment in
complex matrix of functions that make up the business
• Moves the business away from reactive and toward to
proactive
• Informs employees, management, vendors and others about
the strategies and plans for the organization
11
• Strategy Statement
• Industry Analysis and Trends
• Competitive Analysis
• Internal Firm Analysis
Summary Project Plan
Updates Strategy
Resource Name Estimated Effort (hrs)
PM 80
BA 240
Tech 0
BusSME 0
ITSME 40
Sample Project Form with Data

So how do we do it?
12
Step 4
 Looking at only one Criteria (column) at a time, rate the extent to which
each Project meets the Criteria
 Repeat this step for of the Criteria (Column)
 This step is where most of the discussion, debate, and consensus
building comes from and whose success, in part, depends on careful,
effective facilitation
Note:
Steeringctee)
complete
dept.vs.standalone)
resources
Financial Recovery (Workflow) H L M L
Training L L L L
EDI incl IVR and incl legacy 4.2 data (Workflow) L L M L M
Medical Review and Reopenings (Workflow) M M M L

So how do we do it?
13
Step 5
 Calculate a “Priority Score” based upon the H/M/L non-linear scale
 Generally H=9, M=3, and L=1
 MULTIPLY how well the project meets the criteria (column) by the
importance (H/ML) of the column… then add across columns to get
your “Priority Score”
Note:
Steeringctee)
complete
dept.vs.standalone)
resources
Priority
Score
Financial Recovery (Workflow) H L M L 108
Training L L L L 30
EDI incl IVR and incl legacy 4.2 data (Workflow) L L M L M 75
Medical Review and Reopenings (Workflow) M M M L 72

So how do we do it?
14
Step 6
 Rank your projects by Priority Score to provide a view into which
projects will best meet the business objectives/success criteria
Note:
CMS/Internalmandate(externaldrivers,eg.
Hardwarelease,CR,Steeringctee)
Projectisgreaterthan50%complete
Increaseoperationalareathru-put(e.g.
improvedlegacyintegration)
Existingworkflowintegration(intra-dept.vs.
standalone)
ReturnonInvestment(Value/cost)-cost
avoidancenothiringadd'lresources
Priority
Score RANK
1 Financial Recovery (Workflow) H L M L 108 1
4 Training L L L L 30 4
2 EDI incl IVR and incl legacy 4.2 data (Workflow) L L M L M 75 2
3 Medical Review and Reopenings (Workflow) M M M L 72 3

Complete “Actual” Prioritization Matrix
15

We are not done yet! Build a Project Estimate Landscape
16
Icon Track Projects Effort
(hrs)
Duration
(wks)
Organizational
Structure and
Governance
OSG-1: Project 1
OSG-2: Project 2
OSG-3: Project 3
OSG-4: Project 4
360-450
550-690
650-800
3050-3800
3-4
12-16
16-20
30-34
End-to-End
Process
Integration
E2E-1: Project A
E2E-2: Project B
E2E-3: Project C
1100-1375
500-690
1060-1325
8-10
6-8
6-10
Process &
System
Optimization
PSO-1: Project X
PSO-2: Project Y
PSO-3: Project Z
4250-5300
950-1200
600-750
28-34
8-10
6-8
Service Model
SM-1: Project Blue
SM-2: Project Green
700-875
1800-2250
12-16
20-25
 Create Estimates, Rank, and Plot your projects based on business track

17
You can then add a time scale to the project portfolio
Operational Readiness
& BluePRINT™
Project 1: 2Q 2013
Strategic Alignment / E2E
Implementation
(Project Set 3: 1Q/2Q 2014)
Remediation Plan
Implementation
Rapid, Incremental Changes to Generate
Immediate Internal Improvement
Facilitate Best-in-Class
Process Improvement
Current
• Vision, Blueprint,
• Remediation Evaluation
Audit and
Remediation Plan
Product Delivery
(Project Set4: 2014)
Near-Term
• E2E-1 Project A
• E2E-2:Project B
• E2E-3 Project C
• PSO-2: Project Y
• SM-1: Project Blue
2014 and beyond
• OSG-4: Project 4
• PSO-3: Project Z
• SM-2: Project Green
TransformationalStabilization
Short -Term Now
• PSO-1: Project X
Stabilization,
Strategy and
E2E Start Up
Project Set 2:
3Q/4Q 2013
Best in class
organization
Integrated
processes
and service

Let’s Review
• Perform and Operational Assessment, such as a
BluePRINT
• Determine your projects goals, value, and budget as
an input
• Use a QFD based model, such as the Blue Slate
Planning and Decision Making System, to
prioritize your projects/business objectives
• Build your project landscape
• Plot your projects out across a timescale
• Call Blue Slate to help!
18

Questions?
19
David Scholl,
Director
312.626.3918
david.scholl@blueslate.net
Mike Sefransky,
Director
518.810.0375
michael.sefransky@blueslate.net

Project Portfolio Optimization & Blue Print

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