Case study

Responding to disruption in the healthcare industry through enterprise-wide agility transformation

Client: Major healthcare payer

Our Role: Stand up an Agile Center of Excellence (CoE) to drive behavioral change through the entire organization.

Industry: Health Services

Services: Technology, Digital Risk Solutions, Transformation Assurance

Client Challenge:

Avoid disruption by radically accelerating the speed, efficiency and quality of solution delivery

In the Healthcare industry, for both payers and providers, disruption looms on the horizon. Healthcare spending consumes approximately 20% of US GDP and attracts significant investment for disruptors, creating a high-stakes environment for incumbents. Adding to this situation is a fluid and constantly changing regulatory environment, which injects more uncertainty into the industry with each political cycle. This, compounded with the use of legacy technologies, systems, and processes, ultimately contributes to the all too familiar problems seen in healthcare today—rising costs, operational inefficiencies, and sub-optimal experiences for members, patients and customers alike.

To better navigate the dynamic healthcare environment, the VP of IT for a major healthcare payer called on PwC to help transform how solutions are delivered to their customers.

Approach:

Time to do things differently

The VP of IT understood that applying small, incremental improvements to solution delivery could potentially lower costs and improve efficiencies. Pockets of the organization (such as the Digital group) had begun to use the Agile methodology, and were already seeing the benefits—such as enhanced collaboration between Business and IT and faster time to market. This served as evidence that Agile can work in a particular area of the organization. The VP of IT wondered how to scale this more broadly, and asked PwC to help guide this enterprise-wide agility transformation.

PwC began by organizing a summit with executives from the business units to build fluency in Agile and its benefits. The leaders agreed that Agile should be expanded to other areas, but faced a difficult question—how do you change the mindset of an entire organization that has a deeply ingrained way of working?

To deliberately drive this behavioral change, PwC infused experience-hardened change management practices as it stood up an Agile Center of Excellence (CoE). The Agile CoE combined training, coaching, tooling, and knowledge sharing with ongoing governance and monitoring of the transformation. Moreover, rather than a traditional PMO-based planning approach, Agile itself was used to develop and refine the CoE in an iterative fashion.

To expand Agile’s footprint in the organization, the CoE took a pragmatic approach and applied the Scaled Agile FrameworkⓇ (SAFeⓇ) incrementally. Rather than a big bang rollout, the CoE transformed the enterprise via vertical slices (i.e. concentrating on one particular focal area at a time), and worked with the Business and IT leaders in the area to stand-up Agile programs and provided hands-on coaching to drive the adoption of an Agile mindset. Once an area was up and running, the CoE would revisit the organizational landscape and decide the next best area to engage. As this was happening, PwC helped the client build internal capacity through coaching and upskilling, which enabled the client to drive the transformation on their own.

As Agile gained adoption and mindsets shifted to a new way of working, the client became ready to tackle other key areas to enable flow of solution delivery. For example, DevOps (including Testing / Quality Assurance) capabilities were incrementally added to the CoE, further automating and improving the flow of value. Moreover, the team enlisted specialists from PwC’s Risk Assurance and Tax practices to revamp the controls infrastructure to support Agile, DevOps, and Quality Assurance practices, and revisited how capitalization worked within an Agile environment.

Impact:

Measurable improvements in service speed, efficiency and quality

While the transformation is still ongoing, the results stand for themselves:

  • Transformation / Adoption Metrics
    • Trained and upskilled 14,000 executive leadership and staff on Agile and SAFe
    • Launched over 35+ Agile release trains, involving 5,000 staff
  • Performance Metrics
    • Achieved a 10% - 20% reduction in corporate operational expense through the transformational efforts
    • 62% improvement in defect leakage of Agile teams over two years (as compared to the enterprise team average)
    • Reduced cycle time for code compilation and unit testing by 90% through the establishment of Continuous Integration / Continuous Delivery (CI/CD) pipelines
    • 600% increase in the number of automated builds over a 10 month period
    • 3x faster CI/CD pipeline creation through templates and standardization

Furthermore, the client’s success with their agility transformation had one additional, equally powerful benefit. The shift in corporate culture towards self-empowerment has begun to create a continuous learning environment where employees are always looking for ways to improve products and processes, further reducing the cost of service delivery.

“To compete in the digital economy, being agile is a must—and the healthcare industry is no exception. Being agile isn’t just about software, it’s about delivering the whole solution with speed, efficiency and quality, while in parallel, ensuring your employees are energized along the way. At PwC, we do this by engaging our staff across service lines for a more holistic approach.”

Zach Sachen, PwC Principal

Contact us

Jamie  Gunsior

Jamie Gunsior

Principal, Digital Healthcare Leader, PwC US

Niket Desai

Niket Desai

Principal, PwC US

Jerry  Stone

Jerry Stone

Internal Audit, Compliance & Risk Management Solutions Partner, PwC US

Dave  Rudicel

Dave Rudicel

Partner, PwC US

Zach Sachen

Zach Sachen

Principal, PwC US