National healthcare insurance company

Executive summary

Business Challenge

After a national health benefits organization acquired a 900-person non-profit organization in its field, their Vice President and General Manager were given twelve months to achieve four demanding goals:

• Transition the non-profit to a for-profit business with cultural integration.
• Increase operating income by $15 million annually.
• Decrease the cost of care.
• Improve the Great Place to Work (GPTW) score.

Sophia Network was hired to build cultural integration and achieve business results using its systemic methodology. Innovation Ecosystems is a human-centered approach to innovation. It is anchored in listening deeply to participants, deploying rapid prototyping, and generating creative ideas to develop products, services, processes, and organizations.

Business Results

Increased Profitability: The two organizations were successfully integrated and were able to transition to breakthrough levels of profitability. As a result of our implementation process, the company’s operating margin increased by $54 million against a $15 million goal. The company reported $12 million in care-cost savings.

Cultural Change: Most companies benefit from review of their company culture and this client was no different. What made an assessment of company culture imperative was the merging of a non-profit and a for-profit company into one aligned organization, both internally and externally. Through our implementation process, cultural integration was successful and the company’s Great Place to Work score moved from 50 to 70 in one year.

Summary

Dramatic improvements like these required operational and cultural change in the organization. Achieving demanding goals in a rapidly growing company meant overcoming business-as-usual attitudes, risk aversion, and inadequate infrastructure and data tracking. It also required greater focus on a process-oriented culture, brand ambassador development, and engagement of the workforce and stakeholders, with visible, sustainable goals that can be celebrated top-down, bottom-up, and across the company.

This case study illustrates how organizational change was achieved using a well-defined and results-focused design thinking process to embrace aggressive business and growth goals, and how our process led to exciting breakthrough performance. To address the client’s biggest challenges, we focused on both quantitative and qualitative outcomes, then applied a proven process for changing the organization’s vision into action.

Process Overview

How Sophia Network implementation achieves results.

A Process for Productivity

The Sophia Network Innovation Ecosystem Methodology begins with a formative stage that identifies specific and relevant roles of each team member. We use a results-focused model, which appropriately assigns who is Responsible, Accountable, Consulted, and Informed. This model, when used correctly, eliminates pain points and confusion around various roles and accountabilities that, if not established clearly upfront, often result in projects not getting off the ground, stalling, or failing.

Innovation Ecosystems

The Seven-Phase Innovation Ecosystem Methodology

Our proven seven-phase methodology addresses organizational challenges systematically:

Phase 1-2: Release, Align & Frame

Eliminate Cultural Foundation Barriers

• Create structured forums for examining failures without blame
• Confront market realities and aligns around shared challenges
• Change strategies that are actually slow-motion failures
• Build psychological safety needed for breakthrough thinking

Phase 3-4: Infrastructure, Ideate/Prototype

Eliminate Cultural Foundation Barriers

• Mandate dedicated innovation capacity (not optional add-on work)
• Distribute innovation capabilities across the organization
• Establish systematic knowledge transfer
• Create protected time where teams focus entirely on innovation

Real Example: One healthcare insurance organization facing plummeting customer satisfaction and member retention built cross-functional innovation teams. In one year:

• Great Place to Work score moved from 50 to 70
• Voluntary turnover decreased 31%, preserving institutional knowledge
• Cross-departmental collaboration increased 340%

Phase 5-7: Pitch, Integrate/Test, Acknowledge

Eliminate Systems Integration Barriers

• Demonstrate innovation value in financial terms stakeholders understand
• Embed innovations into core operations for sustainable momentum
• Create cultural reinforcement through celebration
• Make innovation cessation more disruptive than continuation

PROJECT OUTCOMES

We coach project teams to address both the “tangibles”, systems, structures, metrics, and the “intangibles”, passion, creativity, design.

Our team alignment process revealed that the 900-person non-profit entity had internal structures that were less rigorous than the for-profit company. This led to an important review that allowed the leadership and stakeholders to efficiently bring the value of the non-profit organization into a rapidly growing for-profit company.

Value Delivered

The Sophia Network team was able to address barriers in the organization, increase goal awareness, embed design thinking principles, and allow natural leaders to emerge from the frontlines of the workforce. As a result, project teams met their strategic business goals, embraced accountability, operated from a team mindset, expressed passion in their work, delighted their customers, and were responsible for significant profit.

In both the short and long term, project teams helped create a resilient, agile, focused, fun culture, and leadership was able to express a vision of the new company with more active engagement of their workforce who continue to feel more productive and valued.

Customers too have been the beneficiaries of these changes. The company reports that customers now consistently communicate their positive brand experience and satisfaction through their feedback channels.

Quotes from Stakeholders

“I never expected there would be such a cultural revolution in just 6 months. I was planning on leaving the company , really glad I stayed!”

“This methodology has affected everything we do and how we think! “

“As a customer, I had problems for years with the company service reps but that is gone. I can tell it’s a different company now.” We have used this process with several clients across various industries and varying in size from $20M to $500M and speed of growth. While each client requires something different given their unique industry and challenges; the core principles have endured across all companies, size, industry and speed of growth.