The Situation:

A large health system wanted to reduce costs related to outside network referrals and maximize internal care referrals. This work involved multiple phases and each one was foundational to the next:

1. Performed a gap analysis of business processes.
2. Identified and facilitated agreement on the performance measures across clinical and non-clinical executive leaders.
3. Prepared business requirements and integrated these into the design for future referrals.
4. Leveraged new opportunities for performance improvement after the new referrals processes were in place.

Elements of the Approach:

• Created and led weekly workshops to identify process gaps and critical leading/lagging measures.
• Created and led large, cross-functional, enterprise-wide team workshops to integrate the business needs to the new platform.
• Using inputs from previous phases, collaborated to evaluate, report and plan the actions for reducing referral costs.
• Collaborated closely with all organizational leaders – both physician and administrative health plan – to perform the phases of this multi-year implementation.

Business Impact:

• Reduced the regional organization’s overall financial risk related to referrals.
• Increased management’s capabilities to reduce current referral costs.
• Provided new management insight into many aspects of the referral process to identify future improvements.
• Increased the organization’s ability to provide a higher quality of care through the improved connection of information across disparate entities, people and processes.

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“Amy Kelling is a credible and knowledgeable thought partner. She is results-orientated, has an ability to “think outside the box” and is a quick study of interpersonal skills which allows her to forge strong working relationships quickly. She was able to assist with communication between the members of our Executive Team. She was able to work the “white space” on the organizational chart and work with the various departments and all levels of our organization.”

Belva Denmark Tibbs, Vice President, Medical Operations
Kaiser Foundation Health Plan Ohio

“Amy demonstrates excellence on complex, cross-organizational business initiatives. She has an innate skill for bringing together disparate pieces of information and people across organizational lines to define and communicate the bigger picture (short term and long term) and the work that needs to be done.”

Ann Scott, Director of Primary Care
Kaiser Foundation Health Plan, Ohio