Agile Transformation in Healthcare Insurance Industry Niket Patel Harrisburg University GRAD 695 PGMT Abstract Agile Transformation in Healthcare Insurance Industry Niket Patel Harrisburg University G

Running head: AGILE TRANSFORMATION IN HEALTHCARE INSURANCE INDUSTRY
Agile Transformation in Healthcare Insurance industry
Niket Patel
Harrisburg University
GRAD 695 PGMT

AGILE TRANSFORMATION IN HEALTHCARE INSURANCE INDUSTRY1
Abstract
Agile transformation in the healthcare insurance industry is an emerging concept in the insurance
sector. The health insurance industries require modern methods to deliver customer service
efficiently due to lots of customer objections and failure in satisfying the ill clients and handling
their records leading to scams in the health insurance sector. The traditional approaches are
misleading. The paper thus focuses on the agile transformation of the small-sized company as a
sample in the health insurance sector. The data needs collection from secondary sources and
validated as per the period and research content. The paper aims to discuss how the area of
customer service requires enhancement on the application of agile methods bringing better
teamwork collaboration, new work techniques and productivity in the organisation by satisfying
its clients.

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Table of Contents
Abstract............................................................................................................................................1
Introduction......................................................................................................................................4
Problem Statement.......................................................................................................................6
Justification..................................................................................................................................6
Hypothesis...................................................................................................................................7
Limitations...................................................................................................................................7
Literature Review............................................................................................................................8
Introduction..................................................................................................................................8
Literature Gap............................................................................................................................15
Conclusion.................................................................................................................................16
Proposed Solution Approach.........................................................................................................17
Purpose of the study...................................................................................................................17
Main results expected................................................................................................................17
Description of problem..............................................................................................................17
How to address the research problem........................................................................................18
The primary approach taken......................................................................................................18
Reasons for taking the approach................................................................................................18
Research method........................................................................................................................18

AGILE TRANSFORMATION IN HEALTHCARE INSURANCE INDUSTRY3
Process of conducting a research study.....................................................................................19
Data collection method..............................................................................................................19
Data collection instruments.......................................................................................................19
Suggestions for further research................................................................................................20
Validity and Reliability of Data.................................................................................................21
Ethical Considerations...............................................................................................................21
Recommendations......................................................................................................................22
Conclusion.....................................................................................................................................23
References......................................................................................................................................24
Bibliography..................................................................................................................................26

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Introduction
Healthcare insurance industry is going under constant pressure because of technological
changes directly impacting their customer experience, technologies of product development and
variety of services offered to clients and their families. It requires the agile transformation in
these industries to maintain the flow with the current trends in the marketplace. The leaders of
the organizational team are enforcing more new techniques to update themselves and the team.
Products like healthcare advice by texting and doctors on demand are becoming more in demand
with consumers and healthcare companies are competing to be at the forefront or pioneer of new
technology to gain consumer market.
A huge population of United States use health coverage premium plans to protect their
health. This give rise to an emerging market in the health insurance sector of the country. As per
the US Census Bureau, the private health insurance coverage is more than the public health
insurance coverage from government as per 2017 reports. The private sector is more on the
metropolitan side. The health insurance market covers lots of policy packages like: Pharmacy
benefits, PPO plans, highly deductible health plans, point of service plans and managed care
plans. The health care industry is mainly involve with covered patients with high premium
policies and there lies perfect competition in the marketplace. There are high chances of new
market entry. The insurance coverage costs are higher with services provided in hospitalization,
emergency care, maternity, drug prescription, rehabilitation care, immunization service and
substance abuse treatment mainly.
Agile transformation is about bringing a change to form teams, reduce any discrepancies
and avoid roadblocks in the fulfilment of the organisational goals. The agility in transformation
required two essential things: the plans of the organisation along with the time required to

AGILE TRANSFORMATION IN HEALTHCARE INSURANCE INDUSTRY5
complete it. Another is the resources available in the company to use and achieve the agility in
business model transformation. In the era of transformation, the organisation as well it is teams
need to adapt to the turbulent external environment of the business ruling the company’s
goodwill and existence. It does not require the urgency and drive to implement the change
management out of force. The organisational people being the crucial resource of the company
should be to support such change. The top management of the company should set a budget and
align the immediate goals with the expected goals as per the new trend through such
transformation.
The agile transformation journey requires the company to:
Step 1: It requires the organisational planning to perform backed up by the data required, and the
present goals with the expectation charted finding the deviation which demands to the working
upon
Step 2: The change required to communicate at all levels of the organisation so that resistance
gets kept to the minimum. Then decision taken based on the behaviour, needs, resources
availability and the skills of the people.
Step 3: It requires the training in the required projects, be it for managers or for team members to
execute the change.
Step 4: The agile approaches perform agile coaching, and it designs the required changes
requiring implementation.
Step 5: It will implement the changes for total quality management.