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Health Care Case Study

Case #3909: Government Regional Operations Center - Call Center Operations

A major multi-state Health Insurance Company formed a wholly owned, for-profit subsidiary to provide coverage and care for active-duty military personnel and their dependants. After securing a government contract to provide services for two major regions, the newly formed subsidiary had only six months to structure, staff and get the organization up and running.

Two large Regional Operations Centers were established and staffed based on information provided by the government. But many of the government's assumptions (e.g., volumes, work content, computer system response and reliability) proved to be in error. The company quickly added resources in an attempt to provide the service levels to which they had committed. But service levels were not met and administrative costs soared.

We were engaged to align staffing levels with the 'true' work content, remove excess costs, and meet the contracted service levels. We accepted the assignment at the start of the second quarter and committed to achieving our goals by the end of the third. In that time, overall expenses were reduced by 24% ($3.4 million) annually, an additional $1.3 million resulted from cost avoidance, and service levels were raised to contract standards.

Engagement Highlights

  • Industry:
  • Health Insurance
  • Client:
  • For-profit Subsidiary of a Multi-state Health Insurance Company
  • Assignment:
  • Reduce expenses while meeting contracted service levels
  • Maintain or improve overall performance
  • Comply with all contract requirements
  • Approach:
  • Organizational Analysis
  • Detailed Process Mapping
  • Rationalization of Resource Utilization
  • Examination of Customer Service Telephone System
  • Develop Scheduling Models Predictive of Daily Needs
  • Redefine Roles and Responsibilities of Staff and Management
  • Implement Customer Service Telephone-tiering System
  • Duration:
  • 26 weeks (4-week Analysis and Design; 22-week Implementation)


  • Delivered Annual Budgetary Savings of $3,450,000
  • Saved $1,300,000 annually through Cost Avoidance
  • Increased Service Levels to Contract Standards

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