Payers

Helping payers optimize health care delivery and improve corporate results across all capabilities

To help healthcare payers health insurance companies navigate an increasingly complex environment, McKinsey brings an unparalleled depth of experience from decades of work in healthcare. We have led projects in a variety of topics and supported business performance and growth with our distinctive capabilities in operational and consumer excellence, digital, technology, analytics, and capability building. We help payers make the following moves:

grow across a broad spectrum of customer-facing dimensions, including customer experience, marketing, sales, and ecosystem strategy and implementation
develop and embed operational- and claims-excellence programs aimed at financial stability and medical-cost management, including payment integrity
create innovative population-health and care-management programs, including strategy, design, and implementation
build the skills necessary to implement improvement programs and to ensure sustainability and continuous capability building
set up for success and be able to realize new opportunities in increasingly digitized business models

Featured capabilities

We invest heavily in developing proprietary tools, databases, and methods.

Financial diagnostic tool: Our proprietary tool provides a detailed and holistic view of financial health based on a few high-impact measures, with a quick and automated diagnosis that leverages standardized payer data.

360-degree diagnostic tool: Our diagnostic tool offers a detailed analysis framework for all steps of the private-health-insurance value chain.

Payer Academy program: We provide training and coaching, combining methodological competencies with industry knowledge, to help payers apply best practices for themselves.

Pulse survey: Our comprehensive measurement model helps in the understanding of drivers of customer experience, down to single interaction points.

Payer-transformation tool kit: Our tool kit captures our insights from supporting the industry’s largest transformations. It covers day-one checklists, tools, benchmarks, capability-building programs, and value-capture opportunities.

Examples of our work

Digital transformation

We helped develop a holistic digital strategy, including the analysis and optimization of processes, focused on customer needs, and use of data and analytics. This included digitization of customer journeys and internal processes, which led to an increase in efficiency of up to 30 percent. We helped create a digital ecosystem for partnerships with other global institutions; development and scaling of digital sales models, supported by a large fund for investment in and integration of start-ups; creation of a center of excellence for advanced analytics and implementation of related solutions; and comprehensive integration of digital services and healthcare services.

Closed-file review

We supported a private French health-insurance company in performing a closed-file review in its transformation journey, weaving in analytics as necessary. The result was an automatized process to identify 12 percent more leakages than before and a savings of €20 million annually on cost base.

Omnichannel transformation

A large German health-insurance organization embarked on a digital omnichannel transformation, expanding across all functions over time. We supported the organization in reinventing the way it serves customers and works with multiple providers to deliver superior quality while simultaneously improving efficiency. We worked hand in hand with the organization to shape the overall transformation, comanaging its delivery and building the capabilities it needed to make the change sustainable.

Holistic transformation

A large regional health-insurance organization struggled over years of financial distress. We helped the organization transform its way of working, improve processes, redesign the organizational operating model and train staff on new capabilities. This holistic transformation helped the organization significantly improve its financial situation and realize an impact of more than €200 million in annual savings. We also helped improve the organization’s quality of care by developing innovative care-management concepts for select conditions, such as chronic wounds, heart failure, and renal failure.