Case Study

Highmark de-risks innovation to transform healthcare

  • Needed to increase innovation without driving up costs
  • Worked with Pega Catalyst™ for three to six months to internalize a six-step innovation methodology
  • Saved more than half a million dollars’ worth of work by identifying the appropriate business challenge to solve for

“We saved five to eight hundred thousand dollars worth of work, that would have accounted for no value to the business. And the other example we're going to solve, it's actually easier to solve, and we're going to save a substantial amount of work in the workflow.”

Paul Jones Vice President, Clinical Systems, Highmark Health Solutions

The Business Issue

Highmark Health Solutions (HMHS), a subsidiary of Highmark Health, was struggling to innovate. The health solutions company delivers solutions and services to insurance companies. The challenge was, clients who range from small to large health plans across the U.S. and other places within the Highmark Health family of companies started to look at HMHS as technicians instead of a solutions provider. Clients didn’t regard the solutions provider as having a point of view in the industry. So, it was time to change – time for HMHS to reinvent itself to be seen as more of an innovative thought leader.

The Solution

In collaboration with its clients, HMHS adopted a six-step innovation model to improve the delivery of new features and functions to the marketplace. Working with consultants from Pega Catalyst™, a consultative offer from Pega, HMHS used design thinking and innovation sprints to approach challenges in a new way and arrive at solutions rapidly. The six steps: frame, focus, spark, catalyze, and scale, help HMHS teams to create innovative solutions to business problems.

The teams comprised a blend of employees from across HMHS and its clients, including systems, architecture, business, user experience, human-centered design, and subject matter experts. The teams would then spend a week to map, sketch, decide, prototype, and test the viability of the solutions to critical business questions.

The Results

  • Saved $500,000 to $800,000 of work by determining the appropriate solution to solve for
  • Identified 29 business outcomes to innovate
  • Used Pega Infinity™ to turn sketches into active prototypes within two days
  • Reduced risk by preemptively determining viability of each sprint, potentially saving between $15,000 to $20,000 per project

Related Resources

  • See how design thinking can help you jumpstart innovation.

  • Want to learn more about Pega Catalyst? Check out this blog.

  • How can you compress months of work into a single week? With design thinking.

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Tags

  • Industry Group: Healthcare
  • Product Area: Pega Platform
  • Challenge: Business Agility