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Value Streams

Health Insurance Value Streams


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The Health Insurance Value Streams comprise all the major value streams typical in a Health Insurance firm. The Health Insurance Value Streams are an essential and integral part of business architecture, and instead of starting from scratch, our pre-built deliverable jumpstarts the process, accelerating time to value.

(As the Health Insurance Value Streams is a digital deliverable, we do not accept returns or issue refunds. Please read the product description carefully before purchasing.)

Health Insurance Value Streams Deliverable:

  • A set of 34 value streams and processes detailing the core/primary activities and secondary/support activities of the value chain. The value streams are decomposed into steps at level 1. (Please note that these are NOT your traditional process maps in swim lane charts with various details. Instead, these are business architecture value streams.)
  • Plus, a bonus deliverable – Value Stream Guide.

Enterprise and Business Architects can use the Health Insurance value streams as a springboard and customize them to the needs of their enterprise.

(Note: While we reference business capabilities, journey maps, and process maps, please realize that this product pertains to only the value streams. We offer other products which span business capabilities. Furthermore, the value streams are in simple PowerPoint format and are editable.)

Health Insurance Value Streams:

Value Streams, in the context of business architecture, represent the sequential set of activities an organization performs to deliver a valuable product or service to a customer. The concept is drawn from lean thinking and helps visualize and optimize the end-to-end flow of information, materials, and services from initial request to delivery. Value Streams provide a holistic view of the business, focusing on how value is created across the organization and emphasizing value-add activities while minimizing waste.

Business Capabilities and Value Streams are complementary aspects of business architecture, acting as the Yin and Yang. Business Capabilities represent what a business does – the inherent capacities the organization must have to execute its mission. They’re stable, strategic constructs that define the potential of the organization. On the other hand, Value Streams reveal how an organization leverages its capabilities to deliver customer value. Together, they provide a comprehensive view of the business, balancing the static (capabilities) with the dynamic (value streams) and integrating strategic intent with operational realities.

Value Streams are particularly critical in the Health Insurance industry, characterized by complex regulations, constant flux, and significant customer touchpoints. They allow insurers to understand and visualize the flow of value from the policy origination to claims payment. This holistic view identifies inefficiencies, redundancies, and bottlenecks, improving service quality, reducing costs, and enhancing customer experience.

Health Insurance firms can leverage Value Streams in several ways. They can be used in designing and optimizing processes such as enrollment, underwriting, claim processing, and customer service. For instance, by mapping the ‘Claims Payment’ value stream, insurers can identify steps that add little or no value to the process, such as manual paperwork, and work towards automating or eliminating them. They can also provide valuable insights for strategic decision-making, such as understanding the impact of new regulations or technologies on existing value streams and designing new value streams for innovative products or services.

Finally, Value Streams can be the foundation for documenting detailed process maps and customer journey maps. By starting with a high-level value stream, business architects can drill down into more granular process maps, outlining the exact steps, roles, systems, and data involved in each activity of the value stream. Likewise, customer journey maps can be created by overlaying the customer’s interactions and experiences onto the value stream. This approach ensures that process and customer journey maps are aligned with the overall flow of value, providing a consistent and integrated view of the business.

Fine Print:

  • We sell digital products, so there are no returns, refunds, or replacements. Therefore, please read the product description carefully before making a purchasing decision.
  • A generic set of deliverables and templates may or may not fit your needs, or the content relevance will vary substantially.
  • Sold on an as-is basis and without any implied or explicit warranties
  • Consultants and firms wanting to use it for their clients have a different pricing models.
  • The sale is for digital products only and does not include customization or implementation help.
  • Please review our standard terms of service.

Health Insurance Value Streams


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