helping health plan cfos succeed in times of disruptive change
Post on 17-Jun-2015
410 Views
Preview:
DESCRIPTION
TRANSCRIPT
Helping Health Plan CFOs Succeed in Times of Disruptive Change
#WDAY @workday
Today’s Lineup
Brian SchmidtHealth Plans Finance LeadDeloitte Consulting
Betsy BlandProduct Strategy, IndustriesWorkday
Geoff RhodesFinancials Sales ConsultingWorkday
Agenda
• Challenges in Future Health Plan Financial Management
• A New Level of Thinking
• Workday Financial Management Demo
About Deloitte… Ranked #1 globally in Life Sciences & Healthcare Consulting and Global
HR Transformation based on revenue and capabilities by Kennedy
Named by Gartner as a “Leader” in the Gartner Magic Quadrant for Global Financial Management Consulting Services
“Gold Standard” for redesigning IT organizations by Forrester
Experienced with Workday:
Over 500 certified Workday consultants
140 implementation projects; most experienced partner leading Workday Financials implementations
Over 2,000 integrations to and from Workday solutions
One of two Workday Big Data Analytics Implementers
Copyright © 2014 Deloitte Development LLC. All rights reserved.
Uncertainty Reigns… Health Plan Financial Management Teams are facing an unprecedented barrage of
challenges
Growth, Market, Regulatory and Affordability challenges increasingly demand Finance input on Corporate strategic decisions
These challenges add complexity to Financial Management, while needing to be addressed in the midst of this highly uncertain environment
Health Plans are looking for opportunities to develop capabilities that help them manage through the uncertainty, increase affordability, and address new reporting and analytic requirements
Nee
ds
Met
By
Current State Desired Future State
Standard Reporting
Ad-hoc Data Mining
Ad-hoc Analysis
Standard Reporting
Ad-hoc Analysis
Ad-hoc MiningE
ffo
rt /
Tim
e D
edic
atio
n
Current State Desired Future State
Analyze Standard Reports
Ad-hoc Data Mining
Ad-hoc AnalysisAd-hoc Analysis
Ad-hoc Mining
Generate Standard Reports
Analyze Standard Reports
Generate Standard Reports
ILLUSTRATIVE ILLUSTRATIVE
Copyright © 2014 Deloitte Development LLC. All rights reserved.
Leverage a business platform that provides:
User-directed, real-time reporting and analytics tools
Process automation, workflow, and audit trail controls
Transparency and ‘drill down’ reporting capabilities
Secure, integrated financial data that provides consistent, reconciled reports
Shift resources away from General Ledger maintenance, to value-added reporting and analytics
Optimize Finance operating model to reduce cost
Health Plan Finance Challenges and Imperatives
Reporting does not deliver insights needed to support market or business decisions
Outdated technology platform limits flexibility to gather, analyze or report on changing business needs
No ‘Single Source’ of Financial Truth - financial data, reporting and analytics are often decentralized
Workflow and audit trails are complex and hard to track
Financial platform is expensive to own and maintain
Current Challenges
Copyright © 2014 Deloitte Development LLC. All rights reserved.
Imperatives for Finance
The Future Brings Even More Challenges for Health PlansIndustry trends and external factors are key drivers of business and strategy decisions for health plans. In turn, those decisions pose important implications for a the Finance function.
Administrative cost pressures
Shift to Retail orientation in health insurance
ACA changes in rating and reporting
Administrative Simplification
ICD-10 Financial implications
Accounting for Exchange and ‘3 Rs’ transactions
New ‘marketplaces’ and geographies in traditional health insurance businesses
Mergers and Affiliations
Diversification plays into non-health insurance businesses
Growth Challenges
Market Conditions
Regulatory Changes
Industry Trends
Finance functions & processes are a potential source of savings
Retail orientation requires Finance to provide innovative views on pricing, underwriting and collections
Significant increase of reporting that may be different than management structures
Insurers need to be prepared for increased audit scrutiny
Increasing demand for data-driven analysis and deeper understanding of profitability drivers – including ‘leading’ indicators
Finance systems and processes need to be scalable, flexible and agile
Finance Implications
Copyright © 2014 Deloitte Development LLC. All rights reserved.
Future Demand for Health Plan Financial Insights
Channel • Direct• Broker/Agent• Exchanges• Associations
Line Of Business• HMO• PPO• POS• Part D• MA
Segment/Customer• Commercial:
• Individual• QHP• Non-QHP
• Large Group• Small Group• Associations• Student• Med Supp
• Government:• FEP• CMS• States
Other dimensions required:• Funding Type (Insured or self-funded)• Member- and Group-Level• Corporate Entity• Geography/Rating Area• Business Unit (affiliate businesses)• Basis of Acctg – including Federal and
State Statutory Requirements
Hierarchy of the dimensions will be critical – and probably ‘customized’ at each health plan – which complicates
cost allocations…
• Medicaid• Dental• Disability• LTC• Supplemental Life
Health Plans are already a complex, finance-related business. Recent diversification trends and new Federal requirements require even more dimensions of health plan financials to be tracked, trended, analyzed and reported.
Copyright © 2014 Deloitte Development LLC. All rights reserved.
Dimensional ‘Views’ ExampleHealth Plans need financial management capabilities that are flexible to report on various dimensions, but being based on the same basic information contained in the general ledger and related financial systems:
Financial Dimension:
Audited Consolidated
FinancialsFederal MLR Report
Qualified Health Plan (QHP) Pricing
Analysis
Basis of Acctg GAAP and/or Statutory Statutory Run Rate
Line of Business All Insurance Only QHP Insurance Only
Customer Segment All Split between Large Group, Small Group and Individual
Split between Large Group, Small Group and Individual
Geography N/A By State Situs By Rating Area within a State
Channel N/A N/A Separately ‘On’ and ‘Off Exchange’
SG&A Expenses All Insurance LOBs, with details on Quality Improvement Activities, Taxes & Assessments separately tracked
N/A
Copyright © 2014 Deloitte Development LLC. All rights reserved.
Leverage a business platform that provides:
User-directed, real-time reporting and analytics tools
Process automation, workflow, and audit trail controls
Transparency and ‘drill down’ reporting capabilities
Secure, integrated financial data that provides consistent, reconciled reports
Shift resources away from General Ledger maintenance, to value-added reporting and analytics
Optimize Finance operating model to reduce cost
Moving Forward On Imperatives
Imperatives for Finance
Does your current business platform support needed flexibility to develop insightful reports and analyzes?
Is your Finance team effectively supporting overall Corporate Strategies with timely and accurate financial information that ‘ties’ to the GL?
Are you spending more time and resources manually piecemealing data from ‘upstream’ systems in order to satisfy reporting requirements?
Are you prepared for additional planned – and unplanned – future reporting and audit requirements?
Are you getting what you pay for?
Assessment
Copyright © 2014 Deloitte Development LLC. All rights reserved.
A New Level of Thinking
Betsy Bland
Workday
WORKDAY CONFIDENTIALWORKDAY CONFIDENTIAL
Top HRProduct
Revolutionizing Enterprise Software
600+customers
23languages
“ If there is one company that we believe could rival Salesforce.com in terms of being a major disruptive force in enterprise software, it is Workday.-Canaccord Genuity Investment Research, May 2011 ”
2005 - 07 2008 2011
Dave Duffield and Aneel
Bhusrifound Workday
200,000 employees
mobile
2010 20122009
Financials
Payroll
Unified Talent & HCM
Integration Cloud
Workday for iPad®
Big Data Analytics
Time Tracking
2013
22
2014
Recruiting
Why Start From Scratch?
13
A New Level of Thinking
New ApproachNew Delivery New Technology
TALENT REVENUE
PROCUREMENT
PAYROLL
TIME TRACKING
EXPENSES
HUMANRESOURCES
FINANCIALS
ACTIONABLEANALYTICS
MOBILE
COLLABORATIONCONSUMER UI GLOBALAT THE CORE
ADAPTIVE FOUNDATION
TECHNOLOGY FOUNDATION EMBEDDED SERVICES
MULTI-TENANT
OBJECT ORIENTED
IN MEMORY
SECURITY
INTEGRATION CLOUD CONFIGURABLE BUSINESS PROCESSES
REPORTING & WORKTAGS
SETTLEMENT ENGINE
GOVERNANCE & COMPLIANCE
BIG DATA
RECRUITING
The Enterprise Cloud for HR and Finance
DEMO
Geoff Rhodes
Workday
Transactions Analytics
GovernanceRisk
Compliance
Workday Platform for the Business Transformation
Mobile & User Experience
Simpler
SmarterInsights
& Analytics
People
Data Process
FlexibilityTo Adapt
Faster
Traditional ERP - Limitations
Journal Entries
CodeBlock
Chart of Accounts
Project
Campaign
Geography/Rating Area
… Anything
Product
Channel
Line of Business
Customer/Segment
BusinessEvents
Insights: Smarter
Workday Confidential
Smarter
Faster
Simpler
…analyze the numbers and provide value back to the business.
Change is inevitable…we’ve improved 80% of our business processes with Workday…
[Our employees] think Workday is the easiest system they’ve ever used…
Contacts
Steven Hanson
VP Sales, Financial Management
Workday
steve.hanson@workday.com
+1-925-951-9047
Brian Schmidt
Health Plans Finance Lead
Deloitte Consulting
bschmidt@deloitte.com
+1-651-235-3326
Thank You
#WDAY @workday
top related