Design For Lean Six Sigma

Improving Member Contact Rate
May 5, 2008 v8.3
0
2008 Healthways, Inc.
(No text required for this slide. Leave up until the presenter steps up to the
podium)
2008 Healthways, Inc. 0

Criteria 1
Project
Selection
and Purpose
Mike Davis
Vice President of Quality
1
Good afternoon, my name is Mike Davis. Im the Vice President of Quality

for Healthways. Let me introduce the rest of our team:
Mike McMillan,
Wendy Faust, and
Pete Kapolas.
I was honored to be the Champion of the cross-functional Member Contact

Rate team and its my pleasure to introduce the story of our successful
journey using the Healthways to Excellence Improvement methodology.

Company Overview
z Healthways develops Health and Care SupportSM solutions

for hospitals, health plans, employers and healthcare
providers to improve patients' health, enhance the
fundamental care experience and reduce the cost of care.
z We are the largest, most experienced health and care

support company in the industry, providing services to
more than twenty seven million people and the physicians
who care for them.
z The majority of our services are delivered telephonically

directly to members and/or physicians.
2
We are here representing Healthways headquartered in Nashville, TN.
Healthways develops Health and Care SupportSM solutions for hospitals,

health plans, employers and healthcare providers to improve patients' health,
enhance the fundamental care experience and reduce the cost of care.
We are the largest, most experienced health and care support company in
the industry, providing services to more than twenty seven million people
and the physicians who care for them.
The majority of our services are delivered telephonically.

Healthways Quality System
The Quality System supports the Quality Management Program by ensuring

systematic monitoring and evaluation of Healthways processes & procedures, and
execution of process improvement initiatives.
Quality
System
Quality Regulatory Process
The Quality Services Compliance Excellence
System is 9Quality 9Accreditation 9Standard
supported by Committee Approaches
three pillars of 9Policy &
9PE Project Procedures 9Established
quality Selection tools &
9Privacy processes
9Survey
9Government 9Dedicated
9Internal & Resources
External 9Risk
Audits Management 9Process
Improvement
9Research training
3
The Quality System supports the organizations Quality Management Program.

The three components of the Quality System are defined as:
Quality Services
Regulatory Compliance
Process Excellence
Process Excellence provides leadership, tools, and training for the organizations
process improvement activity.

1A.a Types of data and tools used to select the project,
and why
Performance Metrics
Operational Reports Member/Colleague Customer Audits

Satisfaction Surveys
Contractual
Requirements Member Record Review
4
Section 1A.a.
Healthways has a vast amount of data available to measure overall performance.
Our contractual requirements typically focus on our ability to decrease healthcare spending
for our member populations and improving our members quality of life.
Our data showed that Customer satisfaction in the area of member contacts was an area of
opportunity and we needed to identify creative ways to improve this in order to meet the
needs of our customers and members while assuring scalable growth.
The Member Record Review is used to measure the quality of our telephonic interactions
with members.
Member and Colleague Satisfaction Surveys are performed annually to assess elements
contributing to member and colleague retention.
Operational Reports provide insight into overall performance indicators such as clinician
metrics, member contact rate and other contract specific measures.
Audits are conducted periodically by customers to assess overall program performance,

medical integrity and adherence to contractual obligations.

1A.a Types of data and tools used to select the project, and why
Healthways to Excellence Methodology
Define Measure Analyze Improve Control
Tollgate Tollgate Tollgate Tollgate Tollgate
Key Steps: 1 2 3 4 5
Define
Define Measure
Measure Analyze
Analyze Improve
Improve Control
Control
Step A: Identify Project Step 1: MSA Step 4: Establish Step 7: Screen Potential Step 10: Develop control
CTQs Process Capability Causes plan
Step B: Develop Team Step 2: Stability analysis Step 5: Define Step 8: Discover Variable Step 11: Determine
Charter Performance Objectives Relationships Process Capability
Step 3: Normality
Step C: Define Process analysis Step 6: Identify Step 9: Test Performance Step 12: Implement
Map / SIPOC Variation Sources capability Process Control
Kaizen Event for rapid improvement
Key Deliverables
9 Required 9 Required 9 Required 9 Required 9 Required
9 List of Project CTQs 9 Measurement System 9 Baseline of Current 9 Develop & pilot best 9 Post Improvement
9 Team Charter Analysis Process Performance solution Capability
9 High Level Process Map 9 Definition for Project 9 Cause & Effect Diagram 9 Test performance against 9 Statistical Confirmation of
or SIPOC metrics 9 List of Statistically control group for similar Improvements
9 8 waste identification 9 Normality Analysis Significant Xs prior period 9 Process Control Plan
9 5 Ss 9 Stability Analysis 9 Process Owner Signoff
9 Tools That May Help 9 Tools That May Help
9 Tools That May Help 9 Tools That May Help 9 Benchmarking 9 Design of Experiments 9 Tools That May Help
9 Project Risk Assessment 9 Data Collection Plan 9 Fishbone Diagram 9 New Process Maps 9 Control Charts
9 Stakeholder Analysis 9 Gage R&R 9 Hypothesis Testing 9 FMEA on new process 9 Hypothesis Testing
9 High Level Project Plan 9 Detailed Process Map 9 Regression Analysis 9 Process Modeling 9 CAP Plan
9 In scope /Out of scope 9 FMEA 9 Takt rate 9 VSM 9 Kanban
9 Customer Surveys 9 Pareto Analysis 9 Spaghetti chart 9 Mistake Proof 9 Visual management
(focus groups,interviews) 9 VSM 9 OPE
5
We utilized the Healthways to Excellence methodology, to assist us in

project selection. This methodology uses Lean Six Sigma tools as a
systematic approach to Process Improvement.
The 5 phases of this approach include: Define, Measure, Analyze, Improve,

and Control.
We will highlight the specific tools we chose to use throughout the

remainder of our presentation.

1A.b Reasons why the project was selected
Target Direction
More is better
Relationships
Less is better
Strong -9
Specific value
Medium - 3
W eak -1
Customization
Interventions
Management
Development
New Product
Management
Telephonic
PSM/HCC
Reporting
Fulfillment
Outcome
Account
Product
Data
Customer CTQ House of Quality
Products that meet our needs 3
Reduced member health costs 5
Healthier members
Member satisfaction and
4
testimony 2
High member participation 4
Reliable and credible indicators
of product performance 4
Responsive & easy
to do Business with 2
Physician adherence to
guidelines 2
A B C D E F G
Highest score 176 56 62 84 116 120 18 87

6
Section 1A.b
This house of quality tool was used to obtain insight into the Voice of the Customer.
The Critical to Quality customer requirements were identified.
A few examples include:
Reduced member health costs

Healthier members
Member Satisfaction and Testimony
High member participation
The score of 176 indicated that telephonic interventions were most important to our
customers.
We felt confident that a project focused on telephonic interventions also

directly supported our corporate strategic objectives - specifically, Deliver on Customer
Promises and Assure Scaled Delivery .

1A.b Reasons why the project was selected
Target Direction
Interactions
Strongly Positive
More is better Relationships
Positive
NLess
egativeis bet ter
Strong -9
Strongly N egative Medium - 3
Specific value
W eak -1
RN campaign
Rules
Campaign
Procedures
Stored
assignments
Member
Dialer logic
Contact Rate
knowledge
Judgment/
Clinician
Telephonic Intervention
Staffing
Level
Telephone Intervention House of Quality
Quantity 5
Quality
5
Timeliness
5
A B C D E F G
90 95 90 30 50 105 90
7
By drilling down into key inputs of the telephonic

process, we received more insight into the areas
of opportunities:
The telephonic inputs included:

Quantity
Quality
Timeliness
The score of 105 indicated that member contact rate is the most
important aspect of telephonic interventions.

1A.c Involvement of potential stakeholders in project
selection
Clinicians Account Managers

Executive Team
Customers&
Members Call Center
Management
PEL Team/Quality Committee
8
Section 1A.c
We received input from a wide variety of stakeholders including:
Clinicians,
Account Managers,
The Executive Team,
Customers,
Call Center Management.
All were in agreement that we should improve our Member Contact Rate in
response to the Voice of the customer and to support our business Model and
company objectives.
The next step in the process was to submit the project to the Quality Committee for
final approval.

selection
Receive
project
recommendation Preliminary
project review
Determine impact
& effort Recommend
projects for
Quality Committee
approval
Execute approved
projects
The Enterprise submission process ensures that there is a stakeholder link

from the senior executive level to the individual colleague level.
This process also allows insight to Process Excellence projects that are
executed at other Business Units to determine if project outcomes may
benefit other Business Units.
9
We have a formal project submission and selection process that ensures

Process Excellence is involved with the most important enterprise projects.
The Quality Committee ensures representation across the entire

organization, and it serves as the quality governing body that helps screen
and select the most impactful projects that align with the company strategies
and goals.
Key participants include members of the Account Team which represent

external customer needs, Product Development, and Call Center
Management which represent internal customer needs. This approach
ensured the stakeholder link not only at the senior executive level, but at the
clinician level as well
This project was presented to the Quality committee and approved.

selection
2. Deliver on Customer Promises 6. Assure Scaled Delivery
10
This is an example of the form used to define projects during the Quality
Committee and project selection process.
A key aspect to be noted is how we ensure corporate strategic objectives are

considered during the project selection process.

selection
Davis
10
This project
has low effort
high impact,
Effort
thus, an ideal 5
Enterprise
project
1
20060522Z3
1 5 10
Impact
11
We used a formal selection process that is based on criteria allowing for

project prioritization.
The project scoring verified the fact that this project had high impact, low
effort status, and therefore was an ideal enterprise project.

selection
Wendy Faust
Team members represent Process Excellence

Leader Karen Holland
stakeholders, suppliers and
Clinician Supervisor
customers Mike McMillan
Process Excellence
Leader
Ann Behrens
Champion Larry Petty
Clinical Director
Workforce Solutions
Mgr
Mike Davis
Vice President Quality
Clinician Focus
Group
Representatives Erik Miller
BI/Reporting
Pete Kapolas
Process Excellence
Leader
Victor Mattingly
Business Technology
Debbie Hatcher
SVP Acct Mgmt
12
A core leadership team was assembled to ensure alignment and buy-in towards
improvement within Healthways.
Team members represented stakeholders, suppliers and customers.

1B.a Affected organizational goals, performance measures,
and strategies
z Healthways goal is defined as:
z To be universally acclaimed for having created a healthier world, one

person at a time.
z The Senior Leadership Team defined 6 Strategic Objectives to

support the achievement of this goal this fiscal year.
z By improving the member contact rate, we will support the

following strategic objectives:
z Deliver on Customer Promises (corporate objective #2)

z Connect with as many members as possible.
z Assure Scaled Delivery (corporate objective #6)

z Define a process that allows us to meet the connectivity needs
of our customers as we continue to grow.
13
Section 1B.a
Healthways goal is defined as:
To be universally acclaimed for having created a healthier world, one person

at a time.
The Senior Leadership Team defined 6 Strategic Objectives to support the

achievement of this goal this fiscal year.
Our project supports 2 of Healthways objectives:
First, improving the member contact rate supports corporate objective #2

defined as Deliver on Customer Promises
Secondly, the process that addresses increased member connectivity

supports our corporate objective #6 defined as Assure scaled delivery.

1B.b Types of project impact on each goal/performance
measure
Problem Statement: Project Success Metrics:

Baseline Target
Currently the Care Enhancement Center (call 100%of Standard
Clinician below
center) is not meeting or exceeding the Performance standard
*
internal standard or customer expectations
for member contact rate. Clinician meeting 100%of Standard
Availability standard *
below 100%of Standard
Call Quality
standard *
Project Goal: * Proprietary
Explore, analyze and implement initiatives that

will improve member contact rate, increase
Impact Summary:
customer satisfaction and improve the productivity
of existing resources. Increased member contacts that decrease

healthcare spending for our member populations.
Key Stakeholders: Cost avoidance related to improved efficiency of
resources at an estimated $3 million dollars.
Clinicians, Account Managers, Call Center
Management, Executive Team, Customers, This project supports corporate strategies #2-

Quality Committee. Deliver on Customer Promises and #6- Solidify
Organizational Foundation for Growth.
14
We used the Project Charter tool to clearly define the scope and improvement
opportunity for this project.
Our problem statement reflects that we were not meeting our internal standards or
customer expectations relative to the member contact rate.
The goal of this project was to increase customer satisfaction and improve the
productivity of our existing resources.
The success metrics were

Clinician Performance
Clinician Availability
Call Quality
The anticipated impact was defined as:
1. Increased member contacts that decrease healthcare spending for our member
population.
2. Cost avoidance related to improved efficiency of resources at an estimated $3 million.

1B.c Degree of impact on each goal/performance measure,
and how this was determined
Healthways Corporate Strategies #2 Project Impact on Corporate Degree of Impact on Corporate
& #6 Strategies #2 & #6 Strategies #2 & #6
1. Performance (Increased number of

successful member calls per clinician per
hour)
# 2 Deliver on Customer
Promises 2. Improved clinician availability
#6 Solidify Organizational
Foundation for Growth 3. Improved Call Quality
Key Metrics to Support Corporate Strategy Current % to Desired % to

standard* standard*
Clinician Performance ( calls per clinician per hour) 60% 100%
Clinician availability 97% 100%
Call Quality 84% 100%
Current State
Desired State
*Proprietary
15
Section 1B.c
Baseline data was used to identify the Current State of the 3 key metrics, while
Customer and Business Feedback determined the Desired State.
Comparing Current versus Desired states helped identify the degree of impact our
Project would have.
Baseline current performance of key metrics was:
Clinician performance 60% to standard

Clinician availability 97% to standard
Call Quality 84% to standard
Our target was 100% or better to standard. Please note that our actual standards are
proprietary.

1C.a Potential internal and external stakeholders, and how
they were identified
S.I.P.O.C. Analysis
Suppliers Inputs Process Outputs Customers

9Account Team 9Contract Specs. Member
Member placed
placed 9Member Calls Internal:
9Reporting 9Health Plan call
call campaign
campaign 9Referrals to 9Clinicians
9Product Policies Specialty 9Account
9Claims 9Work Instructions Clinicians Managers
Auto
AutoDialer
Dialer places
places
Processing 9Staffing model 9Follow up calls 9Executive Team
call
callto
tomember
member
9Dialer 9Clinical 9Call Center
Manager Resources Management
9Operations 9Membership Conversation
Conversation 9PEL Team/Quality
9Call Campaigns completed
completed Committee
9Call Flow MGMT 9Fulfillment
9Clinical Info.
System Documentation
Documentation External:
9Telephony 9Customers
System 9Members
9Training 9Providers
Next
Next call
call
scheduled
scheduled
16
Section 1C.a
We then conducted a high-level SIPOC Analysis to identify the potential key

internal and external stakeholders as well as to validate process scope.
Internal Stakeholders were identified as being part of our telephonic

intervention process: Clinicians, Call Center Management, Account
Management and the Executive Team. These stakeholders had
representation within the project team.
External Stakeholders were identified as our members and customers which

include health plans and employer groups. Member satisfaction surveys and
customer audits provided additional project input. Ongoing customer
feedback was provided by account managers.

1C.a Potential internal and external stakeholders, and how
they were identified
Potential Key Stakeholders
Call Center Mgmt
PEL/Quality Cmte
Executive Team
Account Mgrs
Customers
Fulfillment
Providers
Clinician
Member
Process Steps
Member Placed in Campaigns X X X X X X X
Dialer Places Call to Member X X X X X X
Conversation Completed X X X X X X X X
Documentation X X X X X
Next call scheduled X X X X
17
Each Key Potential Internal and External Stakeholder was assessed against
their level of involvement in each of the major process steps from the SIPOC
Analysis.
Based upon this analysis we determined that Fulfillment and Providers were
not key stakeholders.

1C.b Types of potential impact on stakeholders, and how
these were determined
Colleague
Colleague
Turnover
Turnover
Strategy
Strategy Colleague
Colleague
Alignment
Alignment Morale
Morale
Impact
Impact Financial
Financial
and
and
Cost
Cost Clinical
Clinical
Outcomes
Outcomes
Customer
Customer Member
Member
Satisfaction
Satisfaction Call
CallFlow
Flow
18
Section 1C.b
After we identified our stakeholders, we then examined potential

Stakeholder impacts
Examples of our findings included:
Strategic alignment
Colleague morale
Customer satisfaction
Cost of execution

1C.b Types of potential impact on stakeholders, and how
these were determined
Position on Change
Stakeholder Analysis
Strongly Moderate Moderate Strongly
Who Against Against Neutral For For
Clinicians X O
Account Managers X O
Executive Team X O
Call Center Management X O
PELTeam/Quality Committee X
Customer X
Member X O
19
Section 1C.b
A stakeholder analysis was then used to identify the project impact, change
position, and influencing strategy on each key stakeholder. As this shows the
impact on each stakeholder varied as each listed their specific needs. For example
the Clinician perception ranged from Strongly Against to Moderate For.

1C.c Degree of potential impact on stakeholders, and
how this was determined
Position
Stakeholder on Change
Analysis
Strongly Moderate Moderate Strongly
Who Against Against Neutral For For Impact
Clinicians X O High
Account Managers X O Medium
Executive Team X O High
Call Center Management X O High
PELTeam/Quality Committee X Low
Customer X High
Member X O Medium
20
Section 1C.c
The degree of impact on each key stakeholderhigh, medium, or lowwas
determined not only by their level of involvement throughout the process, but also
their current position on change versus the desired state of accepting change.
As seen here, the stakeholders with the highest degree of impact were Clinicians,
the Executive Team, Call Center Management and Customers.

Criteria 2
Current
Situation
Analysis
Mike McMillan
Process Excellence
Leader
21
Thank you Mike Davis. Hi Im Mike McMillan and Im a member of the

process excellence team at Healthways.

2A.a Methods and tools used to identify potential root causes

Define
Define Measure
Measure Analyze
Analyze Improve
Improve Control
Control
Step 3: Normality
Key Deliverables
9 Required 9 Required 9 Required 9 Required
9 Required 9 Post Improvement
9 Measurement System 9 Baseline of Current 9 Develop & pilot best
9 List of Project CTQs Capability
9 Team Charter
Analysis Process Performance solution
9 Definition for Project 9 Cause & Effect Diagram 9 Test performance against 9 Statistical Confirmation of
9 High Level Process Map or
SIPOC metrics 9 List of Statistically control group for similar Improvements
9 Stakeholder Analysis 9 Hypothesis Testing
9 Gage R&R 9 Hypothesis Testing 9 FMEA on new process
9 High Level Project Plan
9 Detailed Process Map 9 Regression Analysis 9 Process Modeling 9 CAP Plan
9 In scope /Out of scope
9 Customer Survey Methods 9 FMEA 9 Takt rate 9 VSM 9 Kanban
(focus groups, interviews) 9 Pareto Analysis 9 Spaghetti chart 9 Mistake Proof 9 Visual management
9 VSM 9 OPE
22
Section 2A.a
As previously discussed our standard approach to process improvement is
to utilize our Healthways to Excellence Methodology, which incorporates
Lean Six Sigma tools. In accordance to this methodology we used a large
variety of tools to analyze the current situation.
Methods and tools used to identify root causes were as follows.
Measurement system analysis, stability analysis, normality test and Muda

walk.

2A.a Methods and tools used to identify potential
root causes
The integration of
Lean and Six Sigma
allows us to use the most effective and
efficient tools to
drive business results.
23
The Healthways to Excellence Methodology integrates both Lean and Six Sigma
which allows us to use the most effective and efficient tools to drive business
results.

2A.a Methods and tools used to identify potential root
causes
Lean is the creation of Value and elimination of Waste across

multiple process steps
Core processes take too long
Time, effort and material are being wasted
Lean attacks issues that are a mile wide
Resources are limited and overworked
Processes have bottlenecks preventing flow
Six Sigma is increased Quality and reduced Variability within a

critical process
Defective output continually reaches the customer
Past improvements are not sustained
Six Sigma attacks issues that are a mile deep
Root causes of problems remain unknown
Inspection and rework consumes resources
24
Lean is the creation of Value and elimination of Waste across multiple

process steps. Lean addresses issues that are a mile wide
Six Sigma is increased Quality and reduced Variability within a critical

process. Six Sigma addresses issues that are a mile deep
We agreed to use both methods to address the depth and breadth of the
issues.

2A.a Methods and tools used to identify
potential root causes
THE 8 WASTES
z Overproduction
z Inventory
z Waiting
z Transportation
z Movement / Motion
z Over-processing
z Defects
z Talent
25
The Team then identified process gaps by using the 8 Wastes as a reference.
Waste is defined as any activity that creates no value in the eyes of the customer
We conducted a Muda Walk with our clinician focus groups to identify a variety of
wastes. An example included movement/motion involving excessive
documentation within member records.
Our improvement initiatives worked toward decreasing or eliminating the identified

wastes.

2A.b Analysis of data to identify potential root causes
Extremely important to validate the accuracy of your measurement system!
Fitted Line Plot

W rap Time 1 = 0.0030 + 1.011 W rap Time 2
10 S 0.503672
R-Sq 96.6%
R-Sq(adj) 96.4%
8
Wrap Time 1
6
Operational reports from
Hummingbird application
compared with real time
4
observation
2 R2> 90% indicates agreement b/w the two

sources . Yes our system is accurate.
0
0 1 2 3 4 5 6 7 8 9
Wrap Time 2
26
Section 2A.b
We completed our Measurement System Analysis to validate the accuracy of

our reporting system. We did this by comparing data from our reporting
application to actual observed telephonic interaction.
Our findings are as follows:

We achieved an R2 > than 90% indicating agreement between the two
sources. This confirmed that our reporting application system is accurate.

Process Stability Measurement-Baseline
I-MR Chart of Calls/Hour

Mean is stable
UC L
Individual Value
_
X
LC L
1 11 21 31 41 51 61 71 81 91 101
O bser vation
Variation is stable
UC L
M oving Range
__
MR
LC L
1 11 21 31 41 51 61 71 81 91 101
O bser vation
27
We conducted a stability analysis and determined both our mean and

variation was stable. This allowed us to move forward with our analysis and
process improvement initiatives.

Baseline Period
Probability Plot of Calls/Hour
Normal
99.9
P-Value 0.196
99
95
90
80
70
Percent
60
50
40
30
20
10
5
P-value is greater than .05

1
Calls per clinician hour is normal data
0.1
Calls/Hour
28
We performed a normality test on the calls per clinician per hour rate and
verified our data had a normal distribution. This result allowed us to use the
statistical analysis tools designed for normal distributions.

2A.c How stakeholders were involved in identifying
potential root causes
Stakeholder Involvement
Identification of 8 wastes within their operating system.

Clinicians
Identification of barriers to meeting performance metrics.
Account Managers Provided current customer expectations and requirements.
Identification of barriers influencing our current dialer and clinical information system
capabilities.
Call Center Management
Identification of 8 wastes within their operating system.
Identification of barriers to meeting performance metrics.
Customers Customer Audits.
Member Member satisfaction surveys.
Executive Team Set corporate strategic objectives.
PEL Team/Quality
Provided Healthways to Excellence Methodology and process improvement expertise.
Committee
29
Section 2A.c
Numerous stakeholders were involved in identifying potential root causes. Each

stakeholder brought a unique perspective to the problem and provided us with a
comprehensive understanding of potential root causes. This set the stage for the
next phase of our project.
For example, the Clinicians helped identify the 8 Waste and barriers to meeting
performance metrics.

2B.a Methods and tools used to identify the final root causes
Define
Define Measure
Measure Analyze
Analyze Improve
Improve Control
Control
Step 3: Normality
Key Deliverables
9 Required 9 Required 9 Required 9 Required
9 Required 9 Post Improvement
9 Measurement System 9 Baseline of Current 9 Develop & pilot best
9 List of Project CTQs Capability
9 Team Charter
Analysis Process Performance solution
9 Definition for Project 9 Cause & Effect Diagram 9 Test performance against 9 Statistical Confirmation of
9 High Level Process Map or
SIPOC metrics 9 List of Statistically control group for similar Improvements
9 Stakeholder Analysis 9 Hypothesis Testing
9 Gage R&R 9 Hypothesis Testing 9 FMEA on new process
9 High Level Project Plan
9 Detailed Process Map 9 Regression Analysis 9 Process Modeling 9 CAP Plan
9 In scope /Out of scope
9 Customer Survey Methods 9 FMEA 9 Takt rate 9 VSM 9 Kanban
(focus groups, interviews) 9 Pareto Analysis 9 Spaghetti chart 9 Mistake Proof 9 Visual management
9 VSM 9 OPE
30
Section 2B.a
We continued to use the Healthways to Excellence methodology as we

moved into the analyze phase of our project to identify final root causes and
opportunities.

2B.a Methods and tools used to identify the final
root causes
These are our project success metrics

Metric Current State
Availability to standard* 97.6%
Calls per Clinician per Hour- 60%

performance to standard*
Quality* (avg. of 4 quality indicators) 84.0%
Overall Process Effectiveness (OPE) 97.6 X 60 X 84.0= 49.2%
We had a tremendous amount of opportunity!

*proprietary
31
In accordance with the Healthways to Excellence Methodology, we

performed an Overall Process Effectiveness test (OPE) and determined the
following results:
Availability to standard was very high and determined to not be an area of

focus.
Quality, at 84%, could be improved but the team determined that the biggest
impact to improving the member contact rate could be made by focusing on
calls per clinician per hour because the performance was at 60%.
Next we wanted to take a deeper dive to understand the extent of the

opportunity.

2B.a Methods and tools used to identify the final root
causes
Process Capability of Calls/Hour Baseline period
LSL
P rocess D ata W ithin
S tD ev (Within) 0.64745 O v erall
S tD ev (O v erall) 0.64745
Goal- 50% of clinician above standard*
7.7 % of clinicians are above

standard.
The current process is not capable
of producing desired results.
* Proprietary
32
We performed a process capability test on our baseline data comparing

current performance to our desired standard.
This analysis reported only 7.7% of our clinicians were above our standard
expectation.
The current process was not capable of producing the member contact rate
that is required to meet our internal standard or customer expectations.
As previously discussed we were ready to focus on key inputs to the

success metric of calls per clinician per hour.

2B.b Analysis of data to select the final root causes
Provided Key Inputs to calls per clinician per hour and specific factors
influencing those inputs
Provided ideas for improve phase
33
We discussed Root Cause Analysis during our work group brainstorming

session.
We used a Fishbone diagram to identify key

inputs to the success metric of calls per
clinician per hour. This allowed us
to focus on very specific factors that influence
those inputs and served as a good starting
point for our improvement initiatives. Some of
these major inputs include:
1. Availability
2. Talk time
3. Wrap time
4. Unsuccessful call management

2B.c Identification of root causes, and validation of the
final root causes
Relationships
Strong -9
Medium - 3
Contributing Factors W eak -1
Dialer strategy
Guidelines
Documentation
Skills/Typing
Computer
Expectations
Clear
Navigation
Call
Skills
Redirection
Processes
Manual
Telephonic Intervention
Tools
Visibility&
Productivity Root Causes
Availability 5
Talk Time 5
Wrap Time 5
Idle Time 4
Unsucc. Call Management 4
A B C D E F G
Scoring helped to prioritize

actions
171 30 72 64 72 171 45 49
34
Section 2B.c
We used the House of Quality tool to validate our final inputs and
contributing factors. Using this approach allowed us to prioritize our
improvement initiatives.
Our significant contributors to productivity were clear performance

expectations and visibility of data results with the utilization of the right tools.

2B.c Identification of root causes, and validation of the
final root causes
Makes
sense to
me Root Causes
35
We also validated our findings with our key stakeholders to see if our list agreed
with their needs. All stakeholders agreed that we were on target.

Solution
Development
Wendy Faust
Criteria 3 Process Excellence
Leader
36
Thank you Mike McMillan. Im Wendy Faust, also a member of the process
excellence team at Healthways.

3A.a Methods and tools used in development of potential
solutions
Potential Improvement
Initiatives
Documentation guidelines and

training
Computer and typing training
Benchmarking
Automation of several manual
Brainstorming with clinicians to processes

Identification of best practices
relative to call flow
identify potential improvement Intensive individualized coaching of

clinicians
Lunch n Learns focused on the why
Call campaign and prioritization
Ideas. Interviews with other stakeholders strategies
Unsuccessful Call Management
Talk Wrap Alerts
Call modeling
Reexamine staffing guideline
CIS modifications
Reexamine product model
Alter contractual requirements
Hire on-clinicians
Remove LCMs from structure
Flexibility in scheduling
Change CEC Hours
No metric requirements
Site Visits
The 5 Whys
37
Section 3A.a
To identify potential solutions we did a variety of things.
We benchmarked other successful internal productivity improvements projects and

interviewed team members to identify best practices and lessons learned.
Interviews and brainstorming sessions with stakeholders were conducted to gain

buy-in and to identify potential improvement ideas. This allowed us to reduce
resistance to proposed solutions.
We also took a 5-why approach to help identify root causes. This helped provide
insight into actions for improvement.
Finally, team members performed site visits to gain insight into other productivity
initiatives going on across the enterprise.

3A.b Analysis of data used in development of potential
solutions
CQIP Update
April 2007
CQIP Baseline Current Outstanding Recommended Actions

Start Metrics Metrics^ Issues as of For Implementation in
Date April 2007 4/30/07 May
May 2006 2.3 CPH 2.8 CPH 1. Idle Time 1. Explore opportunities for
77.5% TOD 75% TOD campaign consolidation
to minimize need for
clinicians to switch
campaigns.
Annual Cost
Avoidance based Nearly ready for Control
on April metrics= Phase
$ 1.63M
Increase in
successful call
volume- 319/day
August 2.3 CPH 2.8 CPH* 1. NONE 1. Move to Control Phase-
2006 84.2% TOD 85.5% TOD action plan complete- at
2.9 CPH exclusive of
server and campaign
volume issues.
Annual Cost
Avoidance based
on March
metrics=$ 3.62 M
Increase in
successful call
volume- 766/day
* Significant
campaign and
server issues
August 2.6 CPH 2.4CPH 1. Currently 1. Re-start CQIP action plan
2006 75.4% TOD 56.5% TOD focused on calls when time permits.
Expansion/ Up-
sell per BU
Leader- over
50% of staff are
new hires -
Annual Cost causing a
Avoidance based temporary drop
on March in CPH and TOD
metrics= 0 2. Idle Time
Increase in
successful call
volume- 0
Availability
100
Target
90
80
70
.
Potential
60
Improvement
50
TOD
Span Initiatives
40
30 Documentation guidelines and

training
Computer and typing training
20
Automation of several manual
processes
10 Identification of best practices
relative to call flow
0 Intensive individualized coaching of
clinicians
06
/3 06
13 06
15 06
12 6
23 06
27 7
10 7
24 7
23 07
29 6
26 6
/7 6
1/ 6
/4 *
10 7
24 7
14 7
28 7
12 7
5/ 007
7
11 06
00
00
1/ 00
2/ 00
2/ 00
00
00
00
00
10 /2 00
00
3/ 00
3/ 00
4/ 00
4/ 00
5/ 00
00
00
20
20
12 20
20
20
20
Lunch n Learns focused on the why

20
/2
/2
/2
/2
/2
/2
/2
/2
/2
/2
/2
/2
/2
/2
/2
/2
/2
/2
1/
9/
8/
6/
0/
9/
/2
26
/1
/1
7/
9/
6/
10
12
/2
7/
7/
8/
8/
9/
1/
6/
Call campaign and prioritization

11
12
strategies
Unsuccessful Call Management
Probability Plot of SCalls per Hour

Talk Wrap Alerts
Call modeling
Normal Reexamine staffing guideline

CIS modifications
Reexamine product model
99.9 Alter contractual requirements
Location Hire on-clinicians
Minnesota Remove LCMs from structure
99 Nashv ille
Flexibility in scheduling
Change CEC Hours
Pittsburgh No metric requirements
95 Raleigh
90 Seattle
80
70
Percent
60
50
40
30
20
10
5
0.1
0 1 2 3 4 5 6
SCalls per Hour
38
Section 3A.b
The team analyzed operational data coupled with our root cause analysis to
develop a list of potential solutions. This allowed us to focus on factors that
influenced our success metrics and pointed us to potential interventions to
address these opportunities.
For example, an identified root cause was related to ineffective computer skills
during calls. This lead to the creation of an improvement initiative regarding
computer skills.

3A.c Criteria used to select final solution
Im p a c t o n
Im p a c t o n S u c c e s s L ik e lih o o d o f C o rp o ra te
P o te n tia l S o lu t io n s M e tr ic s E a s e o f E x e c u tio n C lin ic ia n S a tis fa c tio n Success O b je c tiv e s * S c o r in g
P r o c e s s G u id e lin e s H H H H H 35
S u p e r v is o r S u p p o r t
T o o ls H H H H H 35
C o m m u n ic a t io n T o o ls H H H H H 35
R e w a rd s a n d
R e c o g n it io n P r o g r a m s H H H H M 32
T r a in in g T o o ls a n d
In fo r m a tio n H H H H H 35
R e p o r tin g T e m p la te s H M H H H 32
D ia le r S tr a t e g y H H M H H 32
E lim in a te P e r fo r m a n c e
E x p e c t a tio n s fo r
C lin ic a n s L H H L L 17
In c r e a s e n u m b e r o f s ta f f L H M M L 17
R E -e v a lu a te P r o d u c t
D e s ig n L L H L M 14
M in im iz e t y p e o f C a lls M L M L L 11
In c r e a s e u s e o f
T e c h n o lo g y M L L L M 11
R e -n e g o t ia te C o n tr a c tu a l
R e q u ir e m e n t s L L L L M 8
H=7 * C o r p o r a te O b je c tiv e # 2 a n d # 6
M =4
L=1
39
Section 3A.c
To select the final solutions, the criteria we used looked at Impact on success
metrics, ease of execution, impact on clinician satisfaction, likelihood of success,
and impact on corporate strategic objectives.
Each of these were given a rank of High, Medium or Low.

3B.a Methods and tools used to select the final solution
Impact on
Impact on Success Likelihood of Corporate
Potential Solutions Metrics Ease of Execution Clinician Satisfaction Success Objectives* Scoring
Process Guidelines H H H H H 35
Supervisor Support
Tools H H H H H 35
Communication Tools H H H H H 35
Rewards and Solutions with the

Recognition Programs H H H H M 32
Training Tools and

greatest scores
Information H H H H H 35
were selected.
Reporting Templates H M H H H 32
Dialer Strategy H H M H H 32
Eliminate Performance
Expectations for
Clinicans L H H L L 17
Increase number of staff L H M M L 17

RE-evaluate Product
Design L L H L M 14
Minimize type of Calls M L M L L 11

Increase use of
Technology M L L L M 11
Re-negotiate Contractual
Requirements L L L L M 8
H=7 * Corporate Objective #2 and #6

M=4
L=1
40
Section 3B. a
To select our final solutions we used our scores from the selection criteria grid that
we previously discussed.
Each ranking of high, medium or low was assigned a numerical score.
The solutions with the highest scores were selected. Examples of those we chose
include:
Process Guidelines
Supervisor Support Tools
Communication Tools

3B.a Methods and tools used to select the final solution
Call completed
Member product design at
Health Plan, Eligible member, established frequency
correct phone available
CUPS, Davox and and call handling
Dialer number, standard
appropriate dx, agreeable
due for a call to call
Successful
call to
Call Dialer member
Campaign generated
Via Davox outbound call
Dialer to member
Members,
Health Plan,
Executive
Leadership,
Shareholders
Clinician
dispositions
call as
successful
Process Mapping Muda Walk
Process Assessment
41
In addition we enhanced and added details to our final solutions through the use of
various methods.
Process mapping was done to identify specific process guidelines that were
needed.
Process assessments were completed to identify specific areas of need related to

training, rewards & recognition and reporting.
A Muda walk helped with the specifics related to communication and supervisor
support tools.

3B.b Analysis of data to select the final solution
Process Capability of Calls per Hour
LSL
P rocess D ata W ithin
S tDev (Within) 0.432934 Overall
S tDev (O v erall) 0.469769
Goal - 50% of clinician above standard
50.8% of clinicians are above

standard.
42
Section 3B. b
We used a capability analysis to verify that that the implemented solutions
improved our key project metrics.
For the performance metric, 50.8% of our clinicians were above our
standard, as compared to 7.7% at the beginning of the project.
Because the performance metric standard is a median of individual clinician

performance, 50.8% equated to achievement of this standard.

3B.b Analysis of data to select the final solution
T Test Pre and Post

Data
T-Test of difference = 0 (vs. not =): T-Value = -5.87

P-Value = 0.000 DF = 184
C26 C31
43
In addition, the 2 sample T-test supported the fact there was a statistically
significant difference between the baseline and post results for clinician
performance.
This was verified by a p value = to 0.000

3B.c Involvement of stakeholders in selection of the
final solution
Potential Solutions Clinician Satisfaction
Process Guidelines H
Supervisor Support Tools H
Communication Tools H
Rewards and Recognition

Programs H
Training Tools and

Information H
Reporting Templates H
Dialer Strategy M
Expectations for Clinicians H
Clinicians served as SMEs
Increase number of staff M regarding Clinician Satisfaction
RE-evaluate Product Design H
Scoring components
Minimize type of Calls M
Increase use of Technology L
Requirements L
44
Section 3B.c
Stakeholder involvement in final solution selection was determined based on their
subject matter expertise. Throughout the entire project all stakeholders worked
closely together to determine project goals, potential and final solutions.
Clinicians served as the subject matter experts for the clinician satisfaction criteria,
providing the rankings of high, medium or low for each potential solution.

final solution
Likelihood of
Potential Solutions Success
Process Guidelines H
Supervisor Support Tools H
Communication Tools H
Rewards and Recognition

Programs H
Training Tools and

Information H
Reporting Templates H
Dialer Strategy H
Expectations for Clinicians L
Increase number of staff M
RE-evaluate Product Design L

Other stakeholder groups served
Minimize type of Calls L
as SMEs regarding Likelihood of
Increase use of Technology L Success
Requirements L
45
Other stakeholder groups including the account team, call center management and
the executive team served as subject matter experts for the selection criteria
pertaining to Likelihood of Success.

final solution
Selection Criteria
Impact on
Impact on Success Corporate
Potential Solutions Metrics Ease of Execution Objectives*
Process Guidelines H H H
Supervisor Support
Tools H H H
Communication Tools H H H
Rewards and
Recognition Programs H H M
Training Tools and

Information H H H
Reporting Templates H M H
Dialer Strategy H H H
Expectations for
Clinicans L H L
Increase number of staff L H L The PEL Team/ Quality committee

RE-evaluate Product
Design L L M
served as the SME regarding Ease
Minimize type of Calls M L L of Execution and Impact on
Increase use of
Technology M L M Success
Requirements L L M
46
The Process Excellence team and the Quality Committee provided input on three
key scoring criteria:
ease of execution
Impact on the projects success metrics
Impact on strategic corporate objectives.

3C.a Final solution, and solution validation
z Process Guidelines
z Call flows and documentation guidelines
z Supervisor support tools
z training modules focused on coaching techniques
z Communication tools
z Visual controls
z Feedback mechanisms for all employee levels
z Setting Clear expectations
z Reporting templates
z Standard report matrix
z Analysis support tools
z Rewards & Recognition Programs
z Training tools and information
z Computer and typing skills
z Customer training
z Understanding the big picture that defines why we are doing what we are
doing
z Comprehensive dialer strategy created
z Campaign and team size increased
z Standard dialer settings established to minimize unsuccessful calls
47
Section 3C.a
The team then defined specific improvement strategies and final
solutions.
Some of these strategies included:
Process Guidelines
Supervisor support tools
Communication tools
Reporting templates
Process Guidelines for example included, suggested call flows for

specific call types and guidelines for the efficient use of the computer
system.

3C.a Final solution, and solution validation
Expected Benefits
Final Solutions Performance Availability Quality Indicators
Process Guidelines X X
Supervisor Support
Tools
X X X
Communication
Tools
X X X
Reporting
Templates
X X X
Rewards and
Recognition X X
Programs
Training Tools and
Information
X X
Dialer Strategy X X
48
An example of a final solution was the Supervisor Support Tool.
This solution provided close interactions between direct supervisors and their
clinicians. Supervisors provided one-on-one coaching and call flow training over a
specific period of time.
Stakeholder team members validated our final solutions by assessing the impact of
each solution on our project success metrics. As previously discussed, the project
success metrics were performance, availability, and quality indicators.

3C.b Tangible and Intangible benefits expected
to be realized
Tangible Benefits Intangible Benefits
9Increase in clinician performance 9Improved morale for clinicians

9External VOC heard!!
9Increased clinician availability 9Simplified work process for
managers
9Improved call Quality 9Allowed for measuring productivity
and fostered consistency across
the enterprise
9Overall Increase in Member
9Involved employees that own the
Contact Rate process
9Clear line-of-sight to corporate
9Cost avoidance related to strategies and shareholders
increased efficiency of existing beneficiaries
resources 9Encouraged camaraderie
9Laid the groundwork for
9Positive impact on program collaboration and support of future
outcomes / Return On Investment projects.
49
Section 3C.b
There were numerous tangible benefits that we expected from this project including:
A positive impact on project success metrics- specifically clinician performance as measured by

median calls per clinician per hour, availability and call quality.
Additionally, we expected that the solutions would impact our overall objective of an
increase in member contact rate and improve program outcomes and Return On Investment.
We also anticipated a significant cost avoidance due to increased efficiency of

existing resources.
Anticipated intangible benefits were provided via colleague surveys and brainstorming
sessions. Examples of intangible benefits included:
Improved morale for clinicians

External VOC heard!!
Employee involvement

3C.c Use of data to justify implementation of
final solution
Calls/clinician/hour
Goal Achieved
103% of standard
Starting Point
60% baseline
Jul Aug Sept Oct Nov Dec
50
Section 3C.c
Through the implementation of our final solutions, we nearly achieved all of

our project success metrics
This slide outlines Clinician Performance, specifically the improvement in

median calls per clinician per hour. This represents an improvement from
60% to greater than 103% of our standard. This put us well on our way to
achieving the project goal of an improved member contact rate.
In addition we saw an improvement in clinician availability to 98% of the

standard.

3C.c Use of data to justify implementation of final
solution
Call Quality Indicators

T r e n d o f I m p r o v e m e n t fo r N a s h v ille C E C
1 0 0 .0 0 %
1 0 0 .0 0 %
1 0 0 .0 0 %
8 4 .6 4 % 9 4 .1 9 %
9 0 .0 0 %
8 6 .6 7 %
7 9 .3 7 % 8 3 .3 3 %
8 0 .0 0 %
7 0 .0 0 % 7 0 .0 0 %
6 0 .0 0 %
5 0 .0 0 %
4 0 .0 0 %
3 0 .0 0 %
2 0 .0 0 %
1 0 .0 0 %
0 .0 0 % Post
D e c e mImplementation
ber M et P ercent
Indicator
P H I - 5 .2 8A
%
M inIndicator
o r P e r m is sB
io n J u ly M e t P e r c e n t
Im p rov em en t
0 .0 0 % I m p r o v e m e n t G o aIndicator
l M a n a g e mC ent Baseline
1 3 .3 3 % S O Indicator
C M a n a g e mDe n t
A Im p r o v e m e n t 7 .5 2 %
Im p r o v e m e n t
* F o r q u e s tio n 1 D , th e re w a s o n ly o n e m e m b e r a u d ite d th a t w a s a p p lic a b le i n e a c h m o n th
51
We achieved our desired outcome in terms of all four quality indicators. We

improved from 84% of the standard to 100% of the standard.

3C.c Use of data to justify implementation of final
solution
z Project resulted in a 65% increase in successful member

contacts within the project call center
z $ 3.3M in cost avoidance
z The Overall Process Effectiveness increased from 49.2%
to 88.3%
z Call Quality improved on 4 major indicators
z A Healthways Center for Health Research study
supporting the project demonstrated a strong correlation
between the increase in call volume and a decrease in
member hospitalization and ER visits.
52
In addition to achieving the project success metrics we realized the overall

project goals. Specifically:
This project resulted in a 65% increase in successful member contacts

within the project call center with $3.3M in cost avoidance.
The Overall Process Effectiveness increased from 49.2% to 88.3%. and call
Quality Improved on all 4 major indicators
A Healthways Center for Health Research (CHR) study supporting the

project demonstrated a strong correlation between the increase in call
volume and a decrease in member hospitalization and ER visits.

Project
Implementation
And
Results
Pete Kapolas
Criteria 4 Process Excellence
Leader
53
Thank you Wendy Faust. I am Pete Kapolas a member of the process

excellence team at Healthways.

4A.a Types of internal and external stakeholder involvement in
implementation
Internal External
Stakeholders Stakeholders
Stakeholder Implementation Activities

Assisted in design/piloting/revision of call process flows
Clinicians Provided input for documentation guidelines
Participation in ongoing communication activities
Communicated changes to their Health Plan Customers
Account Managers
Tracked impact of changes to program outcomes and ROI
Incorporated stretch goals into performance evaluations
Ensured clinical and program integrity were maintained
Executive Team
Conducted clinician and member satisfaction surveys
Created Business 101 training for clinicians
Implemented dialer solutions/settings
Changed supervisor job duties- reassigned tasks
CEC Management Team
Implemented call process flows/visual controls
Created/Implemented Rewards and Recognition Program
Facilitation and coordination of all improvement activities
PEL Team/Quality Committee Creation of standard reporting templates and analysis processes
Provided oversight to the call quality monitoring process
Customers None
Member None
54
Section 4A.a
Stakeholder involvement was crucial to the successful implementation of our final

solutions.
Our team of stakeholders assisted in the implementation of solutions that were

supported by their process knowledge.
Some highlights include:
Clinicians were involved in the implementation of call flows, documentation

guidelines and ongoing communication and feedback activities.
The Call Center Management Team took the lead on the implementation of:
dialer solutions,
job duty modification,
the creation of visual controls,
and the rewards and recognition program.

4A.b How types of resistance were identified and addressed
Area of Resistance/Concern
Impact on Impact on
Learning New Call Quality Clinician Clinician Program
Stakeholder Group Processes Impact Satisfaction Turnover Outcomes/ROI Cost
Clinicians X X X X X
Account Managers X X X
Call Center Management X X X X X X
Customers X X
Member X
Executive Team X X X X X
PEL Team/Quality Cmte X X X X X X
Response
Monthly Communication
Incorporation of Feedback
Marketing the Project
1 on 1 meetings to
address individual
concerns
55
Section 4A.b
The project team identified several areas of potential resistance from the
various stakeholders. This resistance was identified during meetings,
stakeholder surveys and one-on-one interviews.
Examples of resistance included:
Learning new process flows

Call Quality Impact
Potentially negative Impact on culture
Monthly communication, feedback, and marketing the project helped

overcome internal resistance and allowed for operational buy-in.

4A.c How stakeholder buy-in was ensured
Lean Six Sigma 4UP Report

Project: Improving Member Contact Rate Project Phase/Deliverables and Key Indicators:
Status Date: 1- 08- 07 Phase/Deliverable % Complete Status
Project Champion: Mike Davis Define Phase 100%
Completed CT- trees, SIPOC
Process Owner: CEC Management Team Obtained voice of the customer
GB / BB: Wendy Faust

Measure Phase
MBB / BB Mentor: Mike McMillan
Obtained baseline metrics 100%
Team Members: Pete Kapolas, Larry Petty, clinicians, Process Stability and Capability
account team, BT, Reporting MSA completed
OPE
Problem Statement: Currently the CEC is not meeting or exceeding Analyze Phase 100%
the internal standard of a median of 3.0 calls per clinician per hour. This is Process Mapping
resulting in less than optimal member contacts and is causing concern C&E matrices
with our external customers. Normality Testing
Project Objective/Value to be Delivered: Improve Phase 100%

Achieve the Healthways standard for calls per clinician per hour while Action plan established and
maintaining clinician availability and maintaining/improving quality at the implemented
CEC Reaction plan implemented
Control Phase 100%

- Implement Control & Reaction Plan
Project Savings / Benefits:

Recent Accomplishments: Using approved cost avoidance methodology- $ 3.3M
Implemented Reaction plan to assist in use of reports to focus efforts An increase of successful calls per day- 65%
Sustaining cph for last 3 months,
Project Metrics to Standard* Baseline Target Current
Decreased unsuccessful talk and wrap minutes over the past month Calls per Hour 60% 100% 100%
Planned Accomplishments Next Period: Availability 97.6% 100% 98%
Move to control phase- will include response plans for cph, unsuccessful
Quality Indicators A,B,C,D- sustained or improved.
cph, idle, availability and quality measures.
* Proprietary
56
4up to have same fonts.
Section 4A.c
The 4-UP report is a project summary document and was used as the basis for
ongoing meetings and conversations with the stakeholder groups to ensure buy-in.
During these routine status updates, issues, concerns and barriers were discussed
and resolved.

4B.a Plan developed by team to implement solution
CQIP Assessment
Executive Summary
CQIP Assessment
Executive Summary
CQIP Assessment
Executive Summary
Overview: The CQIP assessment summary was conducted the week of 7/31/
on-site at the CEC. Participants included the entire CEC Leadership team, 4
Standard Implementation
LCMs and a clinician focus group consisting of 8 clinicians. Wendy Faust and
Mike McMillan led the assessment process. Larry Petty the dialer manager was
also part of the assessment team, focusing specifically on opportunities related to Process
dialer and campaign strategy. The recommendations made to the CEC
complement current initiatives recently implemented by Ray Schuler and Carla
Dunn.
Summary of Findings:
Strengths: There were several strengths noted during the assessment.

Coordinate pre-visit logistics
These include:
o High quality of member interactions,
o Outstanding enthusiasm and commitment of the entire
leadership team toward process improvement initiatives
o Comfort utilizing data to manage the operation
o A great deal of Pride and a desire to be the best
o High level of morale throughout the CEC
o Tenure of the Leadership Team Probability Plot of Calls per Hour Obtain and analyze baseline date
o Collaboration with the account management team Normal
o Responsive to customer issues/concerns/goals 99.9
C1
May
99 Jun
Jul
95 Aug
90 Sep
CQIP Work Plan
80
70
Oct
Nov On-site assessment
Priority Area of Action Dec
Percent
Responsible Timeline RYG

Focus
1. Dialer
Strategy
Historically AMD and pacing were utilized in a very limited manner. The belief was that AMD was
that there is only a 2-4% return rate for answering machine messages.
60
50 yielding return calls. Data has shown
40
Person
Andy Petrini,
George Nowick
Recommended actions
30
Action items Timeline & Comments 20 RYG
Responsible
Person 10
AMD to be used on all campaigns and 6/20- Permission to use AMD on all contracts has been
5
contracts continuously except on those George received except for Wellmark and HPN. Wellmark is
contracts that require preview and contracts Nowick, Andy conducting an automated message pilot so AMD cannot
which have not approved the use of AMD Petrini be implemented. 7/13-HPNV 1 query results received show
an 8.8% return YTD- Andy and AM to determine next
Utilize Target Percent connect for pacing

6/22/06
George
steps. No data yet available on Wellmark automated
messaging pilot- data available mid-late August.
0.1
Pacing being utilized on almost all contracts/campaigns in
Action Plan
Calls per Hour
strategy- pacing to 10% abort rate standard
by campaign.
Nowick
6/28/06-
CEC- exception is 006 campaigns and Wellmark.
created/implementation by
Campaign forecasting tool to be utilized and George Implemented for all contracts. Strategy implemented to
adhered to for all contracts Nowick,
DCMS, Andy
Petrini
share resources ensuring equal impact of off dialer
activities for all contracts. 7/13- staffing allocation for
teams retooled to ensure more adequate coverage of
stakeholders
contracts especially in FMLA situations.
6/27/06
Begin to use campaign tracking grid George 713- George requested copy of pre-process team
Nowick tracking grid from Larry Petty. To be implemented week of
7/17
6/30/06
Continue use of specialty campaigns to George 7/13-Specialty campaigns expired as of week of 7/10.
target BSC members with successful Nowick Scott Sivik sees a continued need. Andy to request
contacts and/or attempts currently below
contractual requirements
Seattle LT to work with account teams to
6/27/06
Account
continuation from BI.
7/13- consolidation being discussed and analysis of

Ongoing Action plan facilitation by PEL
develop a strategy to consolidate contracts teams, ED, potential combinations underway.
into fewer campaigns to maximize dialer DCMS, DM
efficiency
TBD
State Licensure must be factored into ED Process to ensure 100% of staff have CA/NV licensure is
consolidation strategy well underway. This will assist with campaign
ongoing consolidation.
57
Section 4B.a
The implementation plan included both formal documents and frequent

meetings to ensure deliverables were met on time and stakeholder
buy-in.
Examples of these documents include:
Assessment documents detailing the onsite assessment and identified

issues
Standardized reporting packages included the 4UP as well as project
success metrics.
Action plans detailing the implementation of final solutions.
These documents were used as the basis for ongoing stakeholder

meetings. We found that these ensured that the project was kept on
track and provided a forum for ongoing stakeholder input.

4B.b Procedure, system or other changes made to implement
the solution, and to sustain the results
9Old Process 9New Process

9Inconsistent call flows 9Streamlined standard call flows
9Supervisor primarily task oriented 9Supervisor transformed to coach
9Documentation non- role

standardized/excessive 9Documentation guidelines
9No visual controls 9Visual controls/feedback
9Limited Reporting/Analysis mechanisms

9No formal reward or recognition 9Standard reporting templates and
program analysis process

9No technical skill support 9Reward and recognition program
9Clinicians lacked understanding of
9Business 101 training for all
relationship of metrics to
stakeholders clinicians
58
Section 4B.b
The project resulted in the creation of new key processes.
Examples included:
Streamlined standard call flows

Supervisor transformed to coach role
Standard reporting templates and analysis process.
To elaborate on this one, we designed and rolled-out standardized call
handling reports used at all the call centers.
The Process Excellence team lead meetings with key stakeholders using
standard reporting templates that focused on project success metrics. This
helped to ensure consistency of roll-out and timely completion of project action
items.
These meetings and reports validated process changes were sustained.

4B.b Procedure, system or other changes made to implement
the solution, and to sustain the results
Lessons Learned
9 Use of data and reports are essential

9 Documentation efficiency remains a challenge
9 Change is difficult for many- the why must be frequently
reviewed
9 Quality and Quantity must be balanced to ensure positive
impact on outcomes
9 Clinician buy in is key!
9 Coaching and persistence are the only way to sustain
success.
59
Lessons learned were used to improve the execution plan. These insights
further enhanced the ability to sustain project results and overcome
anticipated resistance to change.
Some examples of the lessons learned include:
Use of data and reports are essential

Quality and Quantity must be balanced.
Clinician buy in is key!
Coaching and persistence are the only way to sustain success.

4B.c Creating/Installing a system for measuring and
sustaining results
Process Name Member Contact Improvement
Reporting Tool Hummingbird Application
Characteristic Output (Y) Overall Process Effectiveness (OPE)
Characteristic Input (X) Performance, Availability, Call Quality
Target 100% for each input
Measurement System Control chart

Bar graph
Population All calls
Frequency Weekly / Monthly
Control Method Defect Per Million Opportunities (DPMO)
Reaction Plan Call Quantity Response Plan
60
Section 4B.c.
The intent of our process control plan was to control the associated process
variables to ensure stability over time.
The control plan was defined and adopted by the stakeholders and process
owners.
The key data elements were performance, availability and call quality. These
elements directly tie to our company strategies of Deliver on Customer
Promises and Solidify Organizational Foundation for Growth.
Our previous measurement system analysis validated that our reporting

application, was an accurate source for this data.
The data was tracked using both control charts and bar graphs over both
weekly and monthly timeframes

sustaining results
Immediate Response Plan Process as of 1-18-2007

Process to be followed daily until metrics achieved for 60 days
61
A key element of the control plan was a detailed response plan to ensure a
timely correction of any process variance.
This plan utilizes standard reporting metrics to address results outside

expectations. This plan requires a drill down to find root cause of why target
was not meet, and action plans are then created to address variance.

sustaining results
zMonitor progress of each site monthly

zDiscuss any unusual variances
zReporting findings to Quality Committee quarterly
Calls per Clinician per Hour by CEC/BU AS of July 31, 2007 Availability by CEC/BU As of July 31, 2007
Baseline Baseline
January January
April April
May May
July July
Site 1 Site 2 Site 3 Site 4 Site 5 Site 6 Site 7 Site 8 Site 9 Site 1 Site 2 Site 3 Site 4 Site 5 Site 6 Site 7 Site 8 Site 9
62
These are examples of the bar graphs reports of key success metrics used
in conjunction with the response plan. The bar graphs were posted in the
call center and shared with the Quality Committee. This kept all stakeholders
informed and helped to ensure that results were sustained.

4C.a Tangible and Intangible results realized
9Expected Tangible Benefits 9Tangible Results Achieved
9Increase in median calls per 967% increase in median calls per

clinician per hour clinician hour
9Clinician availability improved to

9Increased clinician availability nearly the Healthways standard
9Improved call Quality 9Call Quality indicators improved or

maintained
9Overall Increase in Member
Contact Rate 965% improvement in member contact
rate
9Cost avoidance related to

9$3.3 M in cost avoidance
increased efficiency of existing
resources
9Project Research study showed strong
correlation b/w increased member
9Positive impact on program contacts and improved member
outcomes/Return On Investment outcomes/Return On Investment
63
Section 4C.a
The tangible results for this project were:
A 67% increase in median calls per clinician hour

An improvement in Clinician availability to 98% of the Healthways standard
All Call Quality indicators improved or maintained
These improvements resulted in :
A 65% improvement in member contact rate

$3.3 M in cost avoidance
In addition, A Project Research study showed strong correlation b/w increased

member contacts and improved member outcomes / Return On Investment

4C.a Tangible and intangible results realized
9Expected Intangible Benefits Intangible Results Achieved
9Improved morale for clinicians 9Significant improvement in Colleague
9External VOC heard!! Opinion Survey results.

9Simplified work process for managers
9Allowed for measuring productivity and 9Lower turnover rate as compared to

fostered consistency across the previous years.
enterprise
9Involved employees that own the 9Clinicians had metrics presented in a
process real time format to see how well they
9Clear line-of-sight to corporate were performing.
strategies and shareholders
beneficiaries 9This initiative set the stage for other
9Encouraged camaraderie employee-led improvement projects.

9Laid the groundwork for collaboration
and support of future projects.
64
The intangible results for this project were:
A significant improvement in Colleague Opinion Survey results
Achievement of a lower employee turnover rate as compared to previous years.
Clinicians had metrics presented in a real time format to see how well they were
performing.
This initiative set the stage for other employee-led improvement projects.

4C.b How project results link to organizational goals,
performance measures, and/or strategies
Healthways Corporate Project Impact on Corporate Degree of Impact on Corporate
Strategies #2 & #6 Strategies #2 & #6 Strategies #2 & #6
1. Performance (Increased number

of successful member calls per
# 2 Deliver on Customer Promises clinician per hour)
2. Improved clinician availability

#6 Solidify Organizational
Foundation for Growth
3. Improved Call Quality
Key Metrics to Support Corporate Current % Desired

Strategy to % to Current State
standard* standard
*
Desired State
Clinician Performance 103% 100%
Clinician availability 98% 100% Result
Call Quality 100% 100%
Clinician Clinician
Performance Status Performance Availability Call Quality
Baseline 60% 97% 84%
Result 103% 98% 100%
* Proprietary
65
Section 4C.b
There were three key metrics that our project set out to improve:
Clinician Performance;
Clinician Availability;
Call Quality;
Baseline data was used to identify the Current State while Customer
and Business Feedback determined the Desired State.
Results were as follows:
Clinician performance achieved 103% to standard

Clinician availability achieved 98% to standard
Call Quantity achieved 100% to standard
Our target was 100% or better to standard. Please note, the actual
standard is proprietary.

4C.c How results were shared with stakeholders
Process Improvement Communication Ongoing reporting of Key

CQIP W ork Plan
Performance Indicators
Priority Area of Action Responsible Tim eline RYG
Focus Person
1. Dialer Historically AMD and pacing were utilized in a very limited m anner. The belief was that AMD was yielding return calls. Data has shown Andy Petrini,
Strategy that there is only a 2-4% return rate for answering m achine m essages. George Now ick
Action items Tim eline & Com ments RYG

Responsible
Person
AMD to be used on all cam paigns and 6/20- Perm ission to use AMD on all contracts has been
contracts continuously except on those George received except for W ellm ark and HPN. W ellm ark is
contracts that require preview and contracts Nowick, Andy conducting an automated m essage pilot so AMD cannot
which have not approved the use of AMD Petrini be im plem ented. 7/13-HPNV query results received show CQIP Update
6/22/06
an 8.8% return YTD- Andy and AM to determine next
steps. No data yet available on W ellm ark automated
April 2007
Availability
messaging pilot- data available m id-late August. 100
CQIP Baseline Current Outstanding Recommended Actions
Utilize Target Percent connect for pacing George Pacing being utilized on almost all contracts/campaigns in Start Metrics Metrics^ Issues as of For Implementation in
Target
strategy- pacing to 10% abort rate standard Nowick CEC- exception is 006 cam paigns and W ellmark. Date April 2007 4/30/07 May 90
by campaign. May 2006 2.3 CPH

77.5% TOD
2.8 CPH
75% TOD
1. Idle Time 1. Explore opportunities for
campaign consolidation
6/28/06- to minimize need for 80
clinicians to switch
Campaign forecasting tool to be utilized and George Implem ented for all contracts. Strateg y implemented to campaigns.
70
adhered to for all contracts Nowick, share resources ensuring equal impact of off dialer Annual Cost
Avoidance based Nearly ready for Control
DCMS, A ndy activities for all contracts. 7/13- staffing allocation for on April metrics= Phase 60
Petrini teams retooled to ensure more adequate coverage of $ 1.63M
contracts especially in FMLA situations. Increase in 50

TOD
Span
6/27/06 successful call
volume- 319/day
40
August 2.3 CPH 2.8 CPH* 1. NONE 1. Move to Control Phase-
2006 84.2% TOD 85.5% TOD action plan complete- at
2.9 CPH exclusive of
Begin to use campaign tracking grid George 713- G eorge requested copy of pre-process team server and campaign
30
Nowick tracking grid from Larry Petty. To be implemented week of volume issues.
Annual Cost
Probability Plot of SCalls per Hour
20
7/17 Avoidance based
6/30/06 on March
Continue use of specialty cam paigns to George 7/13-Specialty cam paigns expired as of week of 7/10.
metrics=$ 3.62 M 10
Normal
Increase in
target BSC members with successful Nowick Scott Sivik sees a continued need. Andy to request successful call 99.9 0
contacts and/or attempts currently below continuation from BI. volume- 766/day Location
1/1 06
5/2 6
/18 06
06
/30 06
7/2 7
0/2 7
4/2 7
/4/ *
6
26 6
9/9 06
23 06
06
/21 06
/16 06
0/2 7
24 7
07
07
07
5/2 07
6/9 7
23 07
07
11 06
00
00
8/1 00
00
1/2 00
2/1 00
2/2 00
3/1 00
3/ 00
00
/ 20
/20
/20
/20
20
11 20
/20
12 20
/20
/20
/20
/20
/20
/20
/20
/ 20
1/2
9/2
2/2
3/2
6/2
contractual requirements 6/27/06
/7/
/2/
Minnesota
14
28
12
7/
7/1
7/2
10
12
* Significant
8/
9/
4/
4/
5/
6/
12
10
Seattle LT to work with account teams to Account 7/13- consolidation being discussed and analysis of campaign and 99 Nashville
server issues
develop a strategy to consolidate contracts teams, ED, potential combinations underway. August 2.6 CPH 2.4CPH 1. Currently 1. Re-start CQIP action plan Pittsburgh
into fewer campaigns to m aximize dialer DCMS, DM 2006 75.4% TOD 56.5% TOD focused on
Expansion/ Up-
95when time permits.
calls
Raleigh
efficiency sell per BU 90 Seattle
Leader- over
TBD 50% of staff are
State Licensure m ust be factored into ED Process to ensure 100% of staff have CA/NV licensure is new hires - 80
Annual Cost causing a 70
Percent
consolidation strategy well underway. This will assist with campaign Avoidance based temporary drop
ongoing consolidation. on March in CPH and TOD 60
metrics= 0 2. Idle Time 50
Increase in
40
successful call 30
volume- 0 20
10
5
0.1
0 1 2 3 4 5 6
SCalls per Hour
Routine updates with Senior

Feedback and revision Leadership and Key Stakeholders
66
Section 4C.c
Key performance indicators were tracked continually to monitor

performance, provide feedback to the Senior Leadership Team, identify
improvement opportunities with process stakeholders, and implement
improvement actions.
This closed-loop feedback system has led to several enhancements,

ongoing removal of any barriers, and improvements aligned to the changing
needs of external customers as well as business needs.
Results were shared during Quality Committee meetings, call center

leadership and town hall meetings, and during senior leader executive
update meetings.

Criteria 5
Team
Management
And Project
Presentation
Wendy Faust
Process Excellence
Leader
67
Thank you Pete Kapolas. Hello again, I am Wendy Faust, a member of the
Process Excellence Team at Healthways.

5A. How the team members were selected, and how they
were involved throughout the project
Position on Change
Potential Key Stakeholders Strongly
Against
Moderate
Against Neutral
Moderate
For
Strongly
For
Who
Call Center Mgmt
PEL/Quality Cmte
Executive Team
Account Mgrs
Clinicians X O
Customers
Fulfillment
Providers
Clinician
Member
Account Managers X O
Process Steps Executive Team X O
Member Placed in Campaigns X X X X X Call Center Management X O
Dialer Places Call to Member X X X X X PELTeam/Quality Committee X
Conversation Completed X X X X X X X X
Customer X
Documentation X X X X X
Next call scheduled X X X Member X O
Improving Member Contact Team

68
Section 5A
Using our SIPOC and Stakeholder Analysis as a frame of reference, a cross-

functional team was selected that included members from each key process
area.
The team met throughout the project life cycle to provide action plan status,
to ensure progress was ongoing and timelines were met.
Members of this team provided constant updates and received consistent

and productive recommendations throughout the project life cycle.

5A. How the team members were selected, and how they
were involved throughout the project
Project Team Function Team Role Involvement

Vice President,
Mike Davis Quality Project Champion Executive Support, Buy-In and Conflict Mitigation
Mike McMillan Process Excellence Master Black Belt Adherence to Healthways to Excellence Methodology
Wendy Faust Process Excellence Project Manager Lead Meetings, Track Assigned Items, Promote Project
Pete Kapolas Process Excellence Quality Compliance Adherence to Healthways Quality System
Workforce Solutions
Larry Petty Manager Subject Matter Expert Lead Change in Dialer Strategies
SVP, Account
Debbie Hatcher Management Process Owner-Customer Represent Voice of External Customer
Ann Behrens Clinical Director Process Owner- Program Monitor Program Outcome Results
Process Owner-
Erik Miller Reporting Data/Reporting Provide Data and Reports for Analysis of Project Results
Process Owner-
Victor Mattingly Business Technology Technology Lead Change to Clinical Information System/Workflow
Karen Holland Clinician Supervisor Subject Matter Expert Represent Voice of Internal Customer
Clinician Focus
Group Clinicians Subject Matter Experts Represent Voice of Internal Customer
69
This chart shows team member involvement throughout the project. Heres
how they were selected
Criteria for member selection included multi-skill and multi-tasking capability

effective communication and people skills, and the ability to think outside the
box.
Members from our Account Team, Business Technology, Process

Excellence and call centers were selected based on their knowledge, skill set
and ability to represent voices of internal and external customers.

5B. How the team was prepared to work together
Process Excellence Methods Healthways Basic training

9Stakeholder Analysis
9Finance 101
9Waste Identification
9Change Management
9Waste Elimination Techniques
9Code of Conduct
9SIPOC Analysis
9Cultural infusion training
9Gap Analysis
9Basic Facilitation Skills
9Process Failure Mode &
Effects Analysis 9Clinical Outcomes Training
9Root Cause Analysis 9 Meeting Skills
9Visual Management & 9 Brainstorming

Standard Operating 9 Consensus Decision-Making
Procedures
9 Prioritization Techniques
9Action Planning
9 Basic Project Management
9Key Performance Indicators
70
Section 5B
The Process Excellence Training supported the methods outlined in the Healthways
to Excellence approach to Process Improvement. These included instruction on a
wide variety of methods including stakeholder analysis, waste identification and
SIPOC techniques.
Healthways Basic Training focused on team skills that would be needed for success
as well as the financial and outcomes aspects associated with this project. This
included training on meeting skills and consensus decision making techniques.
This training ensured strategic alignment and provided the team with the skills
needed to achieve the desired project results.

5C. How the team managed performance to ensure
effectiveness
Agenda, Minutes, Action Plans
customized for each call center
Ongoing status updates per call
M e e t in g M i n u t e s C Q I P P r o je c t T e a m
D A T E : 6 /2 9 /0 6
A tt e n d e e s : A n d y P e tr in i, G e o r g e N o w i k , S c o t t S i v i k , D e b o r a h G r a y , J e r i Y o u d - O ls e n , T a m m y P u t n a m , S h e r r y
T a p p e r o , J a n e P o w e r s , L e s li e M c G r e g o r , M i k e K e n n e d y , L a r r y P e t t y .
center to Project Champion
T o p ics D iscu sse d
R e v iew o f D i a l e r s t r a te g i e s i n c l u d in g i n c r e a s e d u s e o f A M D , u s e o f c a m p a i g n f o r e c a s t in g
C Q IP A c ti o n to o l in m e e t i n g s , a n d h a v e b e g u n u s e o f c a m p a i g n tr a c k i n g g r id .
P la n I n c r e a s in g u s e o f ta r g e t % c o n n e c t p a c i n g w h i le m a in ta i n i n g a c c e p ta b l e a b o r t
r a te .
D M i n t r o d u c e d T a lk / W r a p A l e r ts t o th e L C M s i n c o n j u n c t io n w i th
U n s u c c e s s f u l C a ll s R e p o r t . T a l k / W r a p A l e r ts c u r r e n tl y s e t a t 3 0 m i n . e a c h w i th
lo s s o f 3 F T E s /d a y a n d lo s s o f 1 .5 F T E s / d a y o n U n s u c c e s s f u l C a l l s R e p o r t .
T a l k / W r a p A l e r ts t o b e i m p le m e n t e d w i t h s ta f f s t a r ti n g o n 7 / 1 5 .
C o a c h i n g i n i t ia ti v e s c o n t i n u i n g r e g a r d i n g T O D w it h w r i t te n a c t io n p l a n s f o r
c l i n i c i a n s b e lo w 8 0 % T O D d u e b y 7 /1 2 .
U s e o f a s t h m a f il t e r f o r B S C t o b e g i n th is w e e k . A ls o e x p l o r i n g u s e o f 0
a t t e m p ts f i lt e r .
T o w n H a l l s c h e d u l e d f o r 7 / 1 1 t o i n c lu d e T h e B i g P i c t u r e p r e s e n t a t io n .
M a n u a l p r o c e s s e s b e i n g e v a l u a t e d a n d s o m e c o n tr a c t s C M m e m b e r s h a v e b e e n
p u t i n t o th e i r o w n c a m p a i g n a s s ig n m e n t , s o t h o s e c a l l s c a n b e m a d e o n d ia l e r . CQ IP W ork Plan
C a l l f l o w a n d d o c u m e n t a ti o n g u id e l i n e t r a in in g i n t h e p la n n in g s ta g e s a w a i t in g
r e t u r n o f T r Priority
a i n e r f r Area
o m v ofa c a ti o n o n 7 / 1 0 . Action Responsible Timeline R YG
N e w H i r e c l a s s Focus o f 8 c li n i c ia n s s t a r t s o n 7 /1 0 . Person Potential Results Time to Control
C o m m e n ts
1. Dialer
Strategy
H istorically AMD and pacing were utilized in a very lim ited manner. The belief was that AM D was yielding return calls. D ata has shown
that there is only a 2-4% return rate for answering machine m essages.
Andy Petrini,
George N owick
Site Results to Date 3.0 cph and 85% TOD % of Potential Achieved Days into CQIP CQIP Phase Phase (days)
E D a d d r e s s e d i s s u e r e g a r d i n g s t a f f in g c o v e r a g e o f B S C c o n tr a c t l a s t w e e k a n d
w i l l m e e t w it h A M .
Action items T im eline & Comm ents RYG
Cost Avoidance Increase in calls/day Cost Avoidance Increase in calls/day
J u n e w r a p ti m e i m p r o v e d f r o m 7 .3 m in . d o w n t o 6 .7 m i n .
R esponsible
A c c o u n t m a n a g e r s lo o k i n g f o r w a r d t o r e p o r ts s h o w i n g p r o g r e s s .
Person
A c c o u n t m a n a g e r s r e p o r t e d n o p r o b l e m s w it h t h e n e w c o m m u n i c a t io n s t r u c t u r e
w i t h th e S e a t t le C E C . AMD to be used on all cam paigns and 6/20- Permission to use AMD on all contracts has been Pittsburgh 3.6M 766 4.8M 1024 75% 300 Control 270
6 / 2 2 - S c o t t S i v i k m e n t i o n e d a n icontracts
s s u e t h a tcontinuously
w i l l i m p a c except
t C Q I Pona cthose
r o s s t h e e n t e r pGeorge
rise received except for W ellm ark and H PN. W ellmark is
r e g a r d i n g m e m b e r s t r a t i f i c a t i o n contracts
l e v e l s . H that
e r erequire
q u e s t e preview
d t h a t Qand
u a l contracts
i t y p r o v i d e Nowick, Andy conducting an autom ated m essage pilot so AMD cannot
a s s i s t a n c e w i t h t h i s . K a t h y E l s a ewhich
s s e r rhave
e p o r tnot
s t happroved
a t t h e r e the
i s ause
g r oof
u pAMD o f i n d i v i d u Petrini
a ls be im plemented. 7/13-H PN V query results received show
w o r k i n g o n th is i n c lu d i n g C U P S , T i m A r tz a n d M a r k H a d e n . K a th y t o s e n d
e m a i l w i t h d e t a i l s t o M i k e D a v i s a n d W e n d y F a u s t . M i k e t o d e t e r m i n e n e x t 6/22/06
an 8.8% return YTD - Andy and AM to determ ine next
steps. No data yet available on W ellm ark autom ated
Phoenix 1.45M 331 1.98 452 73% 210 Control 150
step s. messaging pilot- data available mid-late August.
Utilize Target Percent connect for pacing George Pacing being utilized on alm ost all contracts/campaigns in
strategy- pacing to 10% abort rate standard
by cam paign.
Nowick CEC- exception is 006 campaigns and W ellmark. Hawaii 295,058 69 719,778 169 41% 150 Improve
6/28/06-
F O L L O W - U P I T E M S - I n a d d i t i o n t o t h o s e n o t e d o n A c t i Campaign
o n P l a n forecasting tool to be utilized and George Im plem ented for all contracts. Strategy im plem ented to
D a te Ite m
adhered to for all contracts
W ho
Nowick,
D CMS,DAndy
ue
share resources ensuring equal im pact of off dialer
activities for all contracts. 7/13- staffing allocation for
St Louis 2.35M 496 4.75M 1007 49% 90 Improve
d is c u s s e d D ate
Petrini teams retooled to ensure more adequate coverage of
1. 6 / 2 9 /0 6 R e q u e s t s u b m i t te d t o B I f o r a n a l y s i s o f H P N m e m b e r s W end y 7 /6
contracts especially in FMLA situations.
r e s p o n s e to a n s w e r in g m a c h in e m e s s a g e s w it h d u e d a t e o f
6/27/06 Seattle 1.0M 196 3.9M 771 26% 360 Improve
Begin to use cam paign tracking grid George 713- George requested copy of pre-process team
Nowick tracking grid from Larry Petty. To be im plemented week of Baltimore 1.5M 285 3.87M 748 39% 210 Improve
7/17
6/30/06
Continue use of specialty campaigns to George 7/13-Specialty campaigns expired as of week of 7/10.
target BS C mem bers with successful Nowick Scott Sivik sees a continued need. Andy to request Minnesota 133,371 30 2.1M 469 13% 270 Improve
contacts and/or attempts currently below continuation from BI.
contractual requirements 6/27/06
Seattle LT to work with account team s to Account 7/13- consolidation being discussed and analysis of
develop a strategy to consolidate contracts teams, ED, potential combinations underway. Nashville 1.5M 242 3.28M 560 46% 630 Control 90
into fewer campaigns to m aximize dialer DC MS, D M
efficiency
TBD
State Licensure m ust be factored into ED Process to ensure 100% of staff have C A/NV licensure is Raleigh 1.2M 239 3.57M 724 37% 300 Improve
consolidation strategy well underway. This w ill assist with campaign
ongoing consolidation.
Overall 13.0M 2654 29M 5924 45%
Routine updates
with Senior
Feedback and revision Leadership and Key
To each call center Stakeholders
71
Section 5C
The team used a standardized agenda and minutes template to record

weekly meeting results and decisions. Team progress reports were posted
on the Process Excellence Intranet site and updated as progress occurred.
The Champion, Process Owners, and team members received a Project

Status report consistently with %-Completed-Indicators and barriers
addressed.
Our Champion met with the project Sponsor on a monthly and as-needed
basis to review project status & escalate any barriers.
This closed-loop communication system ensured any resource constraints,

barriers, or emerging requirements were surfaced and addressed in a timely
manner. This proved an effective approach to managing this project to
successful completion.

72
On behalf of our team, thank you for your time and the opportunity to present
our project.
Are there any questions?

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Improving Member Contact Rate

May 5, 2008 v8.3

2008 Healthways, Inc. 0

Good afternoon, my name is Mike Davis. Im the Vice President of Quality

I was honored to be the Champion of the cross-functional Member Contact

2008 Healthways, Inc. 1

z Healthways develops Health and Care SupportSM solutions

z We are the largest, most experienced health and care

z The majority of our services are delivered telephonically

We are here representing Healthways headquartered in Nashville, TN.

Healthways develops Health and Care SupportSM solutions for hospitals,

The majority of our services are delivered telephonically.

2008 Healthways, Inc. 2

The Quality System supports the Quality Management Program by ensuring

The Quality System supports the organizations Quality Management Program.

2008 Healthways, Inc. 3

Operational Reports Member/Colleague Customer Audits

Healthways has a vast amount of data available to measure overall performance.

Audits are conducted periodically by customers to assess overall program performance,

2008 Healthways, Inc. 4

Kaizen Event for rapid improvement

We utilized the Healthways to Excellence methodology, to assist us in

The 5 phases of this approach include: Define, Measure, Analyze, Improve,

We will highlight the specific tools we chose to use throughout the

2008 Healthways, Inc. 5

Highest score 176 56 62 84 116 120 18 87

The Critical to Quality customer requirements were identified.

A few examples include:

Reduced member health costs

We felt confident that a project focused on telephonic interventions also

2008 Healthways, Inc. 6

By drilling down into key inputs of the telephonic

The telephonic inputs included:

2008 Healthways, Inc. 7

Clinicians Account Managers

2008 Healthways, Inc. 8

The Enterprise submission process ensures that there is a stakeholder link

We have a formal project submission and selection process that ensures

The Quality Committee ensures representation across the entire

Key participants include members of the Account Team which represent

This project was presented to the Quality committee and approved.

2008 Healthways, Inc. 9

2. Deliver on Customer Promises 6. Assure Scaled Delivery

A key aspect to be noted is how we ensure corporate strategic objectives are

2008 Healthways, Inc. 10

We used a formal selection process that is based on criteria allowing for

2008 Healthways, Inc. 11

Team members represent Process Excellence

Team members represented stakeholders, suppliers and customers.

2008 Healthways, Inc. 12

z Healthways goal is defined as:

z To be universally acclaimed for having created a healthier world, one

z The Senior Leadership Team defined 6 Strategic Objectives to

z By improving the member contact rate, we will support the

z Deliver on Customer Promises (corporate objective #2)

z Assure Scaled Delivery (corporate objective #6)

Healthways goal is defined as:

To be universally acclaimed for having created a healthier world, one person

The Senior Leadership Team defined 6 Strategic Objectives to support the

Our project supports 2 of Healthways objectives:

First, improving the member contact rate supports corporate objective #2

Secondly, the process that addresses increased member connectivity

2008 Healthways, Inc. 13