There is immense pressure across the entire healthcare landscape to provide higher quality care, improve the patient experience, lower costs, and reduce clinician burnout. Achieving the Quadruple Aim requires that all stakeholders consider new operating models and find new pathways to deliver care. There are pushes to increase access to care, reduce variability, improve consumer engagement, better manage population health, and more. Driving these priorities simultaneously necessitates that affordability and quality be viewed as one in the same, but organizations have historically struggled to find ways of linking the two. That’s where the Oliver Wyman Affordability and Quality Impact (AQI) practice comes into play. We have developed expertise across lines of business that can help organizations identify cost drivers, find efficiencies, improve quality of care, and more.
Through our Affordability and Quality Impact practice, we work closely with our clients to drive outsized and lasting impact. We identify detailed drivers of spend and develop strategies for meaningful medical cost, quality, and experience improvements for our clients and their customers. We support end-to-end transformation and collaborate closely with our clients’ teams to ensure relevancy and actionability of our recommendations.
Deeply credentialed AQI team
Powered by purpose-built AQI assets
Extensive body of AQI work
Expertise across end-to-end strategy, design, and execution
The Affordability and Quality Impact is in our DNA
Our Differentiators
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Our Expertise
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Our Team
Meet our team
Affordability and Quality Impact is in our DNA
Our Expertise
We take great pride in partnering with our clients to drive maximum impact
“I have had the pleasure of working with the Oliver Wyman team on multiple transformational enterprise initiatives over the past several years. The team is extremely talented and consistently exceeds expectations. What differentiates them from other consultants I've worked with is their ability to deeply understand how to connect their work into the broader strategies of our organization. This has been tremendously helpful to ensure our strategies aren't just words on a page but actually get put into action.”
‘’We very much enjoyed working with the Oliver Wyman team to redesign our population health model. Their professionalism, expertise and guidance helped us to accelerate and achieve our goal of a total population health redesign which has resulted in increased member engagement, improved outcomes and a return on investment. I would highly recommend this team!”
“We have had the good fortune of working with the OW team. They are indispensable and bring deep industry knowledge with the ability to fuse many disparate ideas supported by data-driven insights into a well-documented and executable strategic plan.”
Our dedicated team of Affordability and Quality Impact practitioners have executed 60+ projects and delivered over $1B in medical cost savings to clients over the past few years.
Value Based Care
Identified 5-year savings of $600M across all lines business by transitioning 40-50% of total membership to risk.
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Value Based Care
Network and Product Design
Developed an actionable steerage strategy enabling up to $300-500M in savings and drove alignment around a consistent enterprise-wide point of view on steerage.
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Network and Product Design
Utilization Management
Created an integrated Utilization Management and Care Management team to manage a subset of high-cost members and serve as an incubation unit to transform all of the plans’ Clinical Services functions.
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Utilization Management
Social Determinants
of Health
Developed a holistic SDOH enterprise strategy including a detailed initiative list of 30+ priority activities, multi-year roadmap, and business case quantifying potential return up to $19M annual impact through improved outcomes and medical cost savings in Commercial LOB.
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Social Determinants
of Health
Population Health Management
Designed and implemented a next-generation care management and wellbeing offering and operating model for commercial, Medicare Advantage, and ACA lines of business. Secured approval and $100M+ in new investment for implementation and execution of new model, which is slated to drive $200M in annual savings.
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Population Health Management
Pharmacy Management
Worked with a health plan to evaluate the landscape for pharmacy services-assessing opportunities for
impact and growth potential, disruption, outcomes improvement, and development of services to sell to other organizations.
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Pharmacy Management
Medical Cost Action Planning
Designed and implemented a Medical Cost Action Planning solution design and governance structure to identify savings opportunities and coordinate across the client’s functional teams (finance, actuarial, clinical, Rx, etc.) going forward; identified and prioritize eight core initiatives with a potential of $30M annual savings for potential in the MA and ACA lines of business.
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Medical Cost Action Planning
Our deeply credentialed Affordability and Quality Impact team have dedicated their careers to the discipline of improving healthcare affordability, quality and outcomes.
Practice leadership: Our AQI practice is led by a senior team of Oliver Wyman Health and Life Sciences Partners and Principals who partner with our clients from strategy development through design, launch and post launch management of affordability and quality-oriented functions and operations.
Organization Effectiveness: Our OE experts bring experience across clinical training, change activation and monitoring performance for the clinical teams post go-live of new initiatives.
Digital: Our digital experts bring experience in healthcare technology transformation, including platform design, predictive analytics, and machine learning.
Clinical: Our clinicians bring a depth of Medical and Pharmacy expertise to ensure our recommendations align with EBM practices and healthcare delivery operations.
Actuarial: Our dedicated health actuarial practice covers across all lines of medical coverage and ancillary benefits (e.g., stop loss) in topics including cost and utilization trend analysis, program measurements, pricing and risk optimization, predictive modeling, and other actuarial topics.
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Aditional Perspectives
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