Provider Digital Overhaul
MVP Health care works with 60,000+ different medical health professionals and 3,400+ facilities throughout NY and VT. These medical providers deliver care to members and work with MVP insurance for eligibility and coverage information, exchange of health data, claim submission and remittance.
However, the current experience and technology stack enabling these tasks is outdated and costing MVP hundreds of thousands of dollars in call center volume, delayed member care and opening up regulatory risk.
Improving the provider experience became a high priority for the business.
Role
Team
- 1 Product Manger
- 15 Internal Stakeholder Teams
- 1 UX Designer
TimeLine
skills
Impact
- Secured funding and prioritization of digital overhaul; designed and shipped 30+ new web pages
- Estimated decrease in call volume of to provider call center >20% fewer calls related to claim status, >45% less on prior authorization and portal adoption increase from 1 in 5 to 4 in 5 healthcare providers
Discover
Objective: Align teams to a common language and process for the provider journey. I established baseline journey and research through 20+ SME convos, 11 provider interviews and service blueprinting. Prioritized opportunities based on LOE and strategic value
Result: Co created a presentation deck highlighting current state, work-in-progress, opportunities and need for executive support
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Call volume, surveys and provider liaisons all reported provider pain points when dealing with MVP insurance (Payer). In order to create an improved provider experience, meet regulatory requirements and expand the network, I worked to understand the current state and propose actionable opportunities
Define
Objective: Align leadership on prioritized pain points and opportunities; receive executive support to implement changes.
Presented to VP+ level audience 50+ pain points, opportunities, 3 year roadmap and request for governance + funding
Result: Received funding and support to implement digital experience overhaul, communication strategy audit and assess vendors for backed processes (eg. Credentialing)
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Research with Subject Matter Experts
I talked with over 20 subject-matter experts within MVP who work with providers for internal pain points and
as a proxy for provider sentiment. I also interviewed 11 providers directly. I leveraged a boundary object of a slide
with a "chronology of tasks" and a 'behind the scenes' graphic which helped ground the conversation in an
operational process framework.
After collecting data and insights from both internal SMEs and provider offices, I mapped out in a whiteboard a
preliminary skeleton of the provider experience across several dimensions.
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Design
Objective: Audit the current digital ecosystem, map out vendor portal integration, understand tech limitations and build a delivery roadmap.
I performed competitive analysis, built a new IA and navigation, mapped digital user journey, and partnered with stakeholders to understand implementation timeline
Result: Delivered a phased delivery roadmap that aligned technical constraints with business priorities and informed future digital modernization efforts
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Presenting to Leadership
One of the key components in presenting to leadership was up-leveling all the information in the whiteboard into a set of 5 slides; focusing on the pain points discovered, work-in-progress across the org, and opportunities. I mapped the current state of the website through an information architecture diagramming and began to note obsolete content, PDF links, and content categories. I paired this analysis with web traffic details to understand user flows and highly utilized resources.
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Competitive Audit
Looking at competitors, I noted a common framework centered around a Jobs To Be Done mental model, whereby resources were grouped in categories similar to what I had uncovered in research. I mapped common flows and content with that structure approach. While MVP provider team experienced high call volumes, establishing and quantifying the relationship that a poor site experience correlated to increased costs was something I had to communicate to leadership. Furthermore, I also gave an approach of how to solve this issue and a roadmap to deliver incrementally on this goal.
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Synthesize
Objective: Build new digital and self service experience, integrating vendor features, while maintaining visual consistency with member facing product.
Worked within website CMS, collaborated new patterns for design system, partnered with marketing team for roll out and with communications for copy
Result: Worked with 15+ stakeholders from concept-to-design and enabled self-service by launching 30+ web pages, reducing reliance on support
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Design System
Leveraging a low-fi publicly available kit in Figma, I began mocking pages and content and annotating flows, team ownership, copy questions and interactions. This allowed me to gather feedback from stakeholders with a “disposable” design and focus on CTAs.
The challenge was adapting the member facing design system to the content and interactions on the provider side. I worked with another designer and engineers to align on new components, developer timelines and implementation limitations in our current CMS builder. Before building, I assessed 1st which components could be re-used and 2nd modified (Minimal CSS re-work). Third, I built new components and patterns into the shared library to support a universal experience across LOB
Deliver
Objective: Perform user testing with provider groups, measure impact against target metrics, and begin second round of phased delivery (in-progress). I worked with provider liaisons and call center to pull data, presented to leadership impact (in-progress) and began auditing PDF documents
Result: Provider call center estimated to receive >20% fewer calls related to claim status, >45% less on prior auth and portal adoption increase from 1 in 5 to 4 in 5 healthcare providers
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Impact
A smooth PA experience prevents care delays, and allows providers to focus on patient care. By highlighting the online portal, automated phone line and providing expectations of required data, we were able to move from a manual PDF format to an almost entirely digital self-service. By improving the the claim experience, we would increase speeds for reimbursement, minimize denials and reduce costly status chasing
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