30% Productivity Increase and 40% FTE Reduction — While Hitting SLAs for the First Time in Three Years
One of the largest customer-owned health insurers in the United States, serving over 27 million people through its affiliates with health, life, dental, and pharmacy solutions across five states.
Service levels hadn’t been met in three years — and adding headcount wasn’t fixing it
Both the Billing and Enrollment departments were consistently failing to meet customer service levels. Leadership had responded the only way they knew how: adding headcount. Yet even with additional staff, SLA targets remained out of reach. The departments were getting larger, but not more effective.
Compounding the problem was a heavy union presence across Enrollment, creating a perception that performance conversations and productivity metrics couldn’t be introduced. Existing reporting showed none of the operational fundamentals — no individual productivity, no utilization data, no capacity by day of week or time of month, and no true picture of workload by activity.
A recent leadership change put a spotlight on the spending trajectory. The estimated cost of inaction was $6M annually — driven by overstaffing, missed SLAs, and the inability to performance-manage effectively without objective data.
- Service level attainmentMissed 3+ yrsHigh
- Individual productivity visibilityNoneHigh
- Workload allocation balanceUnknownHigh
- Skills gap identificationUnmeasuredMedium
- FTE cost trajectoryIncreasingMedium
The operation didn’t have a staffing problem — it had a 1.5-hour-per-day productivity problem
When Bramble established the first trusted baseline across Billing and Enrollment, the results astonished leadership. Average productive output per FTE was approximately 1.5 hours on a 7.5-hour day. The teams weren’t understaffed — they were dramatically underutilized. Workload wasn’t being allocated effectively, skills gaps were causing constant interruptions, and without data, there had been no mechanism to address either problem.
From missed SLAs and growing headcount to sustained performance — with fewer people
Bramble built the first operational baseline these departments had ever had, revealed the true scale of the utilization gap, and provided the data foundation that delivered results within the first year.
Establish Baseline
Bramble integrated with SAP, WorkDay, CISCO telephony, and the proprietary workflow system to build a trusted baseline. For the first time, leadership could see individual productivity, team utilization, and workload allocation patterns across both departments.
Reveal & Address Root Causes
The baseline exposed two critical friction points: workload wasn’t being allocated effectively (individuals often didn’t have enough work assigned), and skills gaps were causing frequent interruptions that consumed productive time. Both were addressable without hiring.
Sustained Improvement
Billing reduced FTE by 40% through attrition management and performance conversations grounded in objective data. Enrollment used capacity freed by skills training to invest in cross-skilling. Both departments met service levels for the first time in three years.
Results measured from the deployment
These are measured outcomes — not projections. Real operational improvements delivered through Bramble.
“I knew we had capacity but I never thought it would be this much. We used to get nowhere near our service level targets — now we are easily hitting them with fewer people.”
See where your payer operations are losing capacity
We’ll map your billing, enrollment, and member service workflows, establish a trusted productivity baseline, and show you where capacity exists — so you can hit SLAs without adding headcount.
For COOs, VP Operations, and Health Plan Operations Leaders.