a 3-tier approach for using dfss to pull and govern six sigma projects in a transactional...
Post on 22-Nov-2014
999 Views
Preview:
DESCRIPTION
TRANSCRIPT
1WCBF Design for Six Sigma Conference June 10, 2005
6666A 3-Tier Approach for Using DFSS to
Pull and Govern Six Sigma Projects in a Transactional Environment
Leslie Behnke
V.P., Six Sigma Business Excellence
CIGNA Corporation
www.CIGNA.com
2WCBF Design for Six Sigma Conference June 10, 2005
Agenda
About CIGNA
Integrated Enterprise Excellence and DFSS
CIGNA’s 3-Tier Approach
Enterprise Level DMA
Governance Teams
DMAIC & DMADV Project Teams
Summary and Q&A
3WCBF Design for Six Sigma Conference June 10, 2005
CIGNA is a National Insurance Provider
• CIGNA provides employee benefits, including health care products and services, and
group disability, life and accident insurance
• $18B annual revenues, with 28,000 employees, and over 200 years of service
• Service and highly transactional business; no manufacturing aspects
4WCBF Design for Six Sigma Conference June 10, 2005
CIGNA’s Six Sigma History is Relatively New
• Selected Six Sigma as Enterprise-wide Quality Framework in
2003
– Previous Quality initiatives were localized and centered around
accreditation criteria and internal audit functions
– Executive recruited from Motorola to lead the new initiative
– Leading Six Sigma supplier selected to provide Six Sigma training and
technical Support
– Comprehensive Quality Framework defined to include statistical methods,
Lean tools, strategic quality management and behavioral performance
– Senior Leadership support coupled with grass-roots pull deployment
strategy. Six Sigma momentum now gaining rapidly
5WCBF Design for Six Sigma Conference June 10, 2005
• Increasing Pressures:
– From Clients and their Employees, to reduce medical costs without impacting quality
– From Healthcare Providers, to reduce administrative burdens
– From the Competition, to provide the best products and service, at the lowest costs
– From the Government, to comply with increasingly complex regulations
• Unacceptable Levels of Variability
– History of mergers/acquisitions and decentralization had left CIGNA with a proliferation of processes and systems
• Increasing Need for Break-through Products and Services
– Voice of Customer is demanding altogether new levels of product innovation and service delivery
Why DFSS?
6WCBF Design for Six Sigma Conference June 10, 2005
2004 Objective was to Achieve Significant Results, Fast
Use Six Sigma Method to help:– Get 2004 savings from process/productivity improvement– Change culture to have more customer focus and discipline around metrics– Develop future business leaders who understand the end-to-end business processes and have a customer orientation
Six Sigma Strengths:– Metrics and fact based– Customer focus– Cross functional process focus– Financial justification
Potential Target Areas:– Medical Costs– Operational Expenses– Membership– Service– Systems
7WCBF Design for Six Sigma Conference June 10, 2005
CIGNA’s Holistic Approach to Implementing Six Sigma
• Enterprise Level Define-Measure-Analyze (DMA) Work
– End-to-End Process View
– Enterprise-Level Metrics
– Provides basis for identifying highest areas of improvement opportunity
– Provides common context to coordinate and integrate projects
• Governance Teams
– Key metrics for selected high potential areas, linked to above
– Common Quality Assurance framework
– Shared, integrated procedures and training
• Project Teams
– DMAIC, DMADV, Kaizen, other
– Specific, strategic projects
High Level Define-Measure- Analyze to select target area
Governance Level: metrics, QA, P&P’s, Change Mgmt
Specific projects: DMAIC, DMADV, Kaizen events
DMA
Governance
DM
AIC
DM
AD
VK
aize
n
8WCBF Design for Six Sigma Conference June 10, 2005
It all Begins with Targeting the Right Metrics
30,000-Foot-Level
Satellite-Level
High-level control charts are created
• Satellite-level metrics might be reported monthly
• 30,000-foot-level metrics might be reported daily
High-level control charts are created
• Satellite-level metrics might be reported monthly
• 30,000-foot-level metrics might be reported daily
• Satellite-level® metrics* are high level business metrics
• 30,000-foot-level® metrics* are high level operational or Six Sigma/Lean project metrics
* Terminology from CIGNA’s Six Sigma provider, Smarter Solutions, Inc..
9WCBF Design for Six Sigma Conference June 10, 2005
We Start at the Top
Receiving and Processing
Claims
Reconciling and reporting claims
payments
Establishing structure & eligibility
for claims to be processed
The End-to-End Claims Process
The Enterprise DMA begins by defining the end-to-end process and its key output metrics
“30,000 foot” Key Output Metrics:
• Claim payment accuracy
• Claim payment timeliness
• Costs to process claims
2010Subgroup 0
80
75
70
Indiv
idual V
alu
e
X=74.20
3.0SL=80.23
-3.0SL=68.17
876543210
Movi
ng R
ange
R=2.267
3.0SL=7.406
-3.0SL=0.000
2010Subgroup 0
80
75
70
Indiv
idual V
alu
e
X=74.20
3.0SL=80.23
-3.0SL=68.17
876543210
Movi
ng R
ange
R=2.267
3.0SL=7.406
-3.0SL=0.000
2010Subgroup 0
80
75
70
Indiv
idual V
alu
e
X=74.20
3.0SL=80.23
-3.0SL=68.17
876543210
Movi
ng R
ange
R=2.267
3.0SL=7.406
-3.0SL=0.000
10WCBF Design for Six Sigma Conference June 10, 2005
The General Target Area Gets Selected
Receiving and Processing
Claims
Reconciling and reporting claims
payments
Establishing structure & eligibility
for claims to be processed
Sub-processes:
• Provider contract design
Provider data loading
• Benefits structure design
• Client benefits structure load
• Member eligibility loading
Six Sigma tools are employed as part of Enterprise DMA to then select high potential target areas
Enterprise DMA:
• Key E2E Process Output Metrics• Claim payment accuracy• Claim payment timeliness• Costs to process claims
• Voice of Customer• Quality Function Deployment (QFD)• Enterprise-level Cause & Effect Analysis
Enterprise DMA:
• Key E2E Process Output Metrics• Claim payment accuracy• Claim payment timeliness• Costs to process claims
• Voice of Customer• Quality Function Deployment (QFD)• Enterprise-level Cause & Effect Analysis
11WCBF Design for Six Sigma Conference June 10, 2005
Governance Teams Get Established
Receiving and Processing
Claims
Reconciling and reporting claims
payments
Establishing structure & eligibility
for claims to be processed
Sub - processes:
• Provider contract design
Provider data loading
• Benefits structure design
• Client benefits structure load
• Member eligibility loading
Governance Teams are then established to:• Develop lower-level, supporting metrics• Ensure continuous quality improvement structure• Develop policies and a structure for procedures• Facilitate sharing of best practices
Key Output Metrics:
Direct metrics• Data loading accuracy• Data loading timeliness• Costs to load data
Shared Metrics• Provider selection accuracy• Reimbursement accuracy
12WCBF Design for Six Sigma Conference June 10, 2005
Finally, Teams are Launched at Specific Targets
Establishing structure & eligibility
for claims to be processed
Provider data loading
Governance Teams then create project teams• By using info from the Enterprise DMA work• By assessing lower level supporting metrics• By doing mid-level analyses
A – (DMAIC) Loading hospital data
B – (DMAIC) Loading practitioner data
C – (DMADV) Provider Contracting Process
13WCBF Design for Six Sigma Conference June 10, 2005
Metrics and business needs dictate projects
Establishing structure & eligibility
for claims to be processed
Provider data loading projects
A – (DMAIC) Loading hospital data
B – (DMAIC) Loading practitioner data
C – (DMADV) Provider Contracting Process
}Process improvement projects will provide acceptable shorter-term results
} Business competition dictates major improvement needed for longer term:
• Compliance to standards, yielding major costs savings• Accuracy levels to be improved dramatically• Cycle time to be reduced significantly
• Significant technology investment may be required.
2010Subgroup 0
80
75
70
Indiv
idual V
alu
e
X=74.20
3.0SL=80.23
-3.0SL=68.17
876543210
Movi
ng R
ange
R=2.267
3.0SL=7.406
-3.0SL=0.000
2010Subgroup 0
80
75
70
Indiv
idual V
alu
e
X=74.20
3.0SL=80.23
-3.0SL=68.17
876543210
Movi
ng R
ange
R=2.267
3.0SL=7.406
-3.0SL=0.000
2010Subgroup 0
80
75
70
Indiv
idual V
alu
e
X=74.20
3.0SL=80.23
-3.0SL=68.17
876543210
Movi
ng R
ange
R=2.267
3.0SL=7.406
-3.0SL=0.000
Key Output Metrics:• Claim accuracy• Claim timeliness• Cost to process
14WCBF Design for Six Sigma Conference June 10, 2005
DMADV is Guiding the Development of a New Process
Analyze& Improve
•Audit Contracts•Highlight Risks•Improve Operations•Optimize Contracts
•Audit Contracts•Highlight Risks•Improve Operations•Optimize Contracts
Renew &Capitalize
•Identify Renewals•Initiate Renewals•Author & Close
•Identify Renewals•Initiate Renewals•Author & Close
Administer & Comply
•Manage Payments•Manage Obligations•Ensure Compliance
•Manage Payments•Manage Obligations•Ensure Compliance
•Collaborative Negotiation•Sign & File•Contracts Drive Supply Chain or Fulfillment Systems
•Collaborative Negotiation•Sign & File•Contracts Drive Supply Chain or Fulfillment Systems
Negotiate&Execute
Create&Control
•Easy Authoring•Best Practices and Templates •Business, Language & Terms Controls•Review & Approval
•Easy Authoring•Best Practices and Templates •Business, Language & Terms Controls•Review & Approval
New Healthcare Provider Contracting Process
15WCBF Design for Six Sigma Conference June 10, 2005
Internal or external request
1.1 Plan 1.2 Build 1.3 Negotiate 1.4 Execute 1.5 Communicate 1.6 Admin
CMSI – Negotiate and Approve Provider Contract
1.1.1 Workload Planning
1.1.2 Situational
Assessment
1.1.3 Contract Plan
1.2.1 Financial Analysis
1.2.2 Assemble Reimburse
Teams
1.2.3 Assemble Contract
Lanaguage
1.2.4 Review &
Management Approval
1.3.1
Present
1.3.2
Update
1.3.3
Withdraw/ Terminate
1.4.1
Sign
1.4.2
Distribute and Store
1.5. 1 Communicate to apropriate
parties
1.5.2
Communicate to appropiate
users
1.6.1
Administer Templates
1.6.2 Administer
Internal Organization
1.6.3 Administer
External Organization
1.6.4
Administer Reports and
Queries
1.6.5
Manage Contracting
Process
Critical-to-Quality Items are being Built into new Process
1. Capability to support contract negotiation
preparation, planning, and contract maintenance.
2. Faster and more comprehensive access to data and documents that support contract
negotiations.
3. Faster, easier contract creation
and storage.
4. Increase quality of contract content through standards,
compliance, and review.
5. Support higher quality negotiations
with providers.
6. More robust communication and document
routing capability.
7. Ongoing process improvement framework capability.
16WCBF Design for Six Sigma Conference June 10, 2005
Increase profitable
growth
Business PrioritiesStrategy High Potential Areas Projects
Best Practice Sharing Process (Govern)
ReduceMedical
CostsScorecard Development Team (Govern)
A Rod
L Javit
Black/Green Belt
Provider Contracting
Process
B Black
R KabooOptimize TPV Networks (DMAIC)
Provider Contracting Process (DMADV) N Kidd
J Q PublicEstablish Provider Data Loading Quality
Assurance Program (Govern)
Provider Site Consolidation (DMAIC) P Luto
Contract Billing Process (DMAIC) M Mouse
Strategic Business Initiative (SBI) Charts* Show Linkages
Laboratory contract loading (DMAIC) G Green
Executive Sponsor:
T SmithK.Jones
J Rogers
Hospital contract loading (DMAIC)
* Terminology from CIGNA’s Six Sigma provider, Smarter Solutions.
17WCBF Design for Six Sigma Conference June 10, 2005
Six Sigma is a Catalyst for Delivering Synergy
Cross-functional Six Sigma teams enhance communications across divisions, focused on common goals and metrics.
• Shared metrics
• Common language/approach
• powerful statistical tools
18WCBF Design for Six Sigma Conference June 10, 2005
In Summary
• DFSS is more than just DMADV projects– It can be used to help execute business strategy and flow down
metrics– It can be used to help select, categorize and prioritize projects
• CIGNA is using a 3-Tier approach to Six Sigma deployment, based in part on the overall concepts in DFSS– Enterprise-level DMA– Governance Teams for High Potential Areas– Strategic Projects (DMADV, DMAIC, other)
• This is highly applicable in our transactional service business.
19WCBF Design for Six Sigma Conference June 10, 2005
What questions do you have?
top related