Corporate Capabilities Presentation - 2014

•Established in 2004, Advanta is a boutique professional services firm providing project execution to public and private sector healthcare organizations.

•As transformation contractors, we partner with clients to architect and execute organizational and operational changes enabled by technology.

• National firm with headquarters in California and 5 satellite locations across the United States.

• Our Client Promise: To successfully complete critical projects that deliver tangible results.

Corporate Snapshot

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• Experienced consultants (minimum of 15 years each)

• Professional careers as leaders within insurance companies, health care providers, and as consultants with one or more of the large international firms

• Credentialed individuals, e.g., PMP, ITIL, Scrum Master, CPA, and Six Sigma

• Skilled in operations and business-information systems integration

• A mix of full time Associates and long-term partners with niche expertise

Our Team

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Delivery Model

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Results-Driven Transformation Model

Assess • Establish the goal

• Understand the impact

• Define the scope

• Establish the commitment

Sustain • Enable new operating

model

• Commit to change

• Achieve benefits realization

Transform • Lead the change

• Organize the effort

• Drive integration

• Build for success

RESULTS

Execution Services

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Assess • Strategic Alignment

• Organizational Readiness

• Project Charter and Scope

• Project Prioritization

• Governance Model

Sustain • Benefits Realization

• Performance Management Systems

• Benefits Modeling

• Project Execution Reporting

Transform • Project Leadership

• PMO Office

• Operations Redesign

• Process Improvement

• Change Management

• Technology Integration

RESULTS

Core Service Offerings

Advanta is all about successful Project Execution that deliver tangible results.

• Project/Program leadership – organize, build and staff the teams, processes and tools necessary to complete projects. We specialize in:

– Business requirements elicitation and documentation

– Use case development

– Budget management

– Risk management

– Communications and change management

– Project planning and scheduling

• Process improvement and redesign

– Simplify policies, processes, procedures, practices and operating models

– Standardize practices and methods

• End-to-end revenue cycle representing both provider and payer sectors

– Regulatory compliance, e.g., ICD 10 and HIPAA

– Inpatient and ambulatory coding

– EDI

– Billing and claims management systems

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Selected Client List

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• Department of Veterans Affairs

• WellCare Health Plans

• UHG - Optum

Advanta Healthcare Partners prides itself on working with a select group of clients and maintaining long term working relationships. Our client list includes:

Major Healthcare Providers

Federal Government

Health Insurance Companies

• Boston Medical Center

• Boston HealthNet

• Universal American Medical Corporation

Our Value to Clients

• We get things done! An established track record of successful project execution.

• We assemble experienced professionals with healthcare industry, functional and leadership qualifications and credentials

• Experience in both the business and IT parts of the organization

• Our experience in both the public and private sectors allow us to bring lessons learned and current practices between the sectors

• Our staff have the experience to advise and coach our clients with broad strategic and operational issues and challenges facing them

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FEATURED PROJECTS

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Featured Projects – Private Sector

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Featured Project

Business Challenge Advanta Solution

Facets System Implementation

The executives of a national Medicare Advantage health plan identified a strategic objective to adopt a common information systems platform for all of its products in the Medicare eligible population. As a part of this common platform objective, the health plan had selected the TriZetto hosted Facets product as the core claims processing system. The operations leadership of the health plan required consulting expertise to work with their end users and the health plan's Information Technology (IT) Department to implement Facets within the HMO product line.

Advanta staffed a project team including the Project Manager, who was experienced with Facets implementations. Advanta was engaged to support the business community during the requirements elicitation, business process and desktop workflow development, system configuration, testing, staff training and post-deployment phases of the system migration project.

Organizational and Operational Redesign

This national behavioral health insurer that had grown by acquisition into large organization that lacked standardization in processes and consistency in terms of how it interacted with members and providers. The leadership embarked upon a transformation of the organization, operations and information systems/technologies to a more efficient and customer friendly entity.

Advanta was engaged to provide a range of program management support activities, including project management standards, communications, change management, financial analysis and risk management. In addition, Advanta provided key program and project managers for selected areas of the transformation initiative as well as business process architecture and analytical resources.

Featured Project

Business Challenge Advanta Solution

Operation’s Strategy and Business Planning

The leadership of a national senior market health insurance company identified the need to improve customer service levels and reduce operating expenses by streamlining processes and more effectively integrating existing information systems and technologies to support business operations. The organization was faced with the need to identify, design and implement a solution within an 18-month time period.

Advanta was engaged to assess the current state of the Operations Division and develop an overall strategy and tactical plan for achieving the stated goals. Advanta facilitated the leadership group through a 'future state' session to define what the Operations Division leadership's vision would be at the end of each of the successive three years. Advanta facilitated the identification of tactical business projects required to accomplish the vision and goals. The final deliverable included a strategy for achieving improved operational performance and a sequenced tactical project plan with preliminary budget and work plan for accomplishing the project.

Program and Project Management

The leadership of the Operations Division of a national health insurer had developed a performance improvement plan designed to improve customer service levels and scores as well as reduce operating expenses. The plan required the initiation and completion of seven initial projects (in 18 months), from technology-based to operational change-based, for achieving the identified goals. The leadership needed assistance in creating an appropriate oversight organization for the $10 million portfolio of projects.

Advanta was engaged to organize, implement and staff a formal program management organization to support the Operations Division's effort for improving customer service and reducing operating expenses. As part of establishing the program management office (PMO), the Advanta Team initiated a number of oversight processes, provided the Program Manager, as well as the Project Managers for six of the seven projects within the program. The PMO presented periodic executive status reports to all levels within the company. Additionally, the PMO managed the program and individual project budgets and scopes utilizing appropriate processes with key client executives for variance decisions.

Featured Projects – Private Sector

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Featured Project

Business Challenge Advanta Solution

Support to an IT Program Executive Office

This Cabinet-level Department of the Federal Government was faced with coordinating the exchange of clinical and demographic data of active military staff and veterans with other Federal agencies, as well as State agencies and private organizations. A Program Executive Office (PEO) was created within the Department's Office of Information and Technology and was in need of consulting support to establish the processes, tools and infrastructure required to be an effective entity.

Advanta identified, designed, built and implemented a management framework for the newly created PEO that included standard portfolio and program management processes and tools, as well as functions such as human resource management and budgeting. Advanta staffed the core PEO functions of performance monitoring, budget analysis, long range planning and communications.

Facilitation of Data Sharing between Federal Agencies

The 2007 Task Force on Returning Global War on Terror Heroes identified the need to improve the delivery of Federal services and benefits to the service members and veterans of the Global War on Terror (GWOT). The Task Force identified a number of recommendations around increasing the sharing and exchange of service member and veteran data between the Departments of Veterans Affairs (VA), Defense (DoD), and Health and Human Services (HHS). There was a need to understand the magnitude of all current efforts and define the plan for moving forward.

The Advanta Team conducted and documented a general business analysis of all pertinent legislation and recommendations. This analysis resulted in the creation of a master library of all requirements related to data sharing between the DoD and VA. These were mapped to ongoing and/or planned projects and programs being sponsored and funded by the two Cabinet-level Departments. An inventory of existing systems and programs supporting inter-agency information sharing outside of the two Departments was created. The Advanta Team also identified opportunities that would enable the exchange of medical and demographic data among Federal agencies and private organizations.

Featured Projects – Public Sector

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Featured Project

Business Challenge Advanta Solution

Veteran Relationship Management (VRM) Program Support

Veteran Relationship Management (VRM) is one of the major initiatives that the Secretary established for the Department of Veteran Affairs (VA) in 2009. The purpose of the VRM initiative is to leverage cutting-edge technologies to engage, empower and serve Veterans by providing seamless, secure and on-demand access to benefit information and services that are better aligned with Veterans’ needs and preferences.

Advanta, as a subcontractor to and in partnership with Systems Made Simple (SMS) and now High Performance Technologies Inc. (HPTi, a DRC company) provides program management support for the VRM Program Management Office (PMO) VRM IT Director and his leadership team within VA OI&T in all aspects of program management, including: define, document and implement operational needs, establish a project framework, integrate internal and external communications, create a financial management structure, and model a future state of VRM.

Health Care Efficiency (HCE) Program Support

Health Care Efficiency (HCE) is one of the major initiatives that the Secretary established for the Department of Veteran Affairs (VA). This initiative was established to coordinate and accelerate the ongoing cost savings initiatives with new initiatives to allow VA to enhance services to clients, with primary goals to: improve patient experience by minimizing variation in service, achieve cost savings and cost avoidance, and create organizational efficiencies by streamlining and minimizing manual processes.

In partnership with prime contractor FirstView Federal, Advanta’s contract with HCE began in May 2011 and is currently ongoing. Working together with the Chief Business Office (CBO) and the Office of Information and Technology (OI&T), our primary role on this project has been to provide project management expertise and support, including planning, business integration liaison, risk and issue tracking, meeting facilitation, schedule management, change control facilitation and PMAS documentation. We provide program management, IT, and financial support to ensure that the proposed contracted solution(s) are developed, tested, and implemented to meet all end user requirements, while simultaneously fulfilling PMAS and ProPath regulations and staying within scope, cost, and schedule.

Featured Projects – Public Sector

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