Changing Change Healthcare
Case Study: Scaled Agile Transformation at Change Healthcare Technology Enabled Services (TES)
This case study reflects work led by Michael Renna, Founder of Alacient, during his tenure as Executive Director of Technology at Change Healthcare Technology Enabled Services. The transformation was executed in partnership with CHC leadership and a team of SPCs and illustrates the operational impact of Scaled Agile practices applied at enterprise scale.
Background
Change Healthcare, following the combination of McKesson’s Technology Solutions business with Change Healthcare Holdings, became one of America’s largest independent healthcare technology companies — serving roughly 5,500 hospitals and over 800,000 clinicians. The Technology Enabled Services (TES) business unit provides critical revenue cycle management and builds internal products that support the company’s revenue streams.
The Challenge
TES faced mounting pressure to deliver value faster in a rapidly evolving healthcare landscape. The Affordable Care Act and increasing payer complexity demanded smarter, more automated systems. TES struggled with delivery transparency, aligning technology activity with business strategy, and sustaining employee engagement. Development and back-office processes needed to be rethought to improve efficiency, quality, and predictability.
The Solution: SAFe Adoption Led by Michael Renna
As Executive Director of Technology, Michael Renna directed TES’s adoption of the Scaled Agile Framework (SAFe). Key steps:
- Secured executive buy-in and educated the core team.
- Partnered with CA Technologies for training and tooling.
- Trained over 200 employees in SAFe, with 36 leaders certified within six months.
- Rolled out agile practices across all technology teams — including leadership, who modeled agile behavior by operating as a scrum team.
- Implemented Big Room Planning to drive collaboration and dependency management.
In parallel, Michael led a two-year, agile-based infrastructure modernization running alongside the SAFe rollout.
Outcomes and impact
Unlike a transformation measured primarily in financial terms, the results here are largely operational — and directly attributable to the work led.
Delivery transformation (directly attributable)
- Release predictability improved from 68% to 96% in six months — the headline result, enabling faster, more reliable product launches.
- 200+ employees trained in SAFe; 36 leaders certified within six months.
- Leadership adoption of agile practices, modeling the behavior for the organization.
- Big Room Planning and supporting tools (CA Agile Central, FlowDock) improved transparency, trust, and cross-team coordination.
Infrastructure modernization (directly attributable)
- Modernized and migrated 100+ platforms and 1,500 servers — the systems underpinning approximately $1B in annual revenue — with zero disruption to service.
- Maintained continuous operation of 50+ live systems serving 32,000 users and $15B in transactions.
- Drove a cloud migration to Microsoft Azure, introducing DevOps and security practices and reducing cloud costs by 25–30%.
On the $1B figure: this describes the annual revenue the migrated platforms supported, and the scale of what was moved without disruption — not revenue “saved.” The defensible, and more credible, claim is the scope and zero-disruption execution, not a counterfactual about revenue at risk.
| Metric | Before | After | Attribution |
|---|---|---|---|
| Release predictability | 68% | 96% (in 6 months) | Directly attributable |
| SAFe-certified leaders | 0 | 36 (in 6 months) | Directly attributable |
| Employees trained | — | 200+ | Directly attributable |
| Platforms / servers migrated | — | 100+ platforms, 1,500 servers, zero disruption | Directly attributable |
| Cloud cost | baseline | −25–30% | Directly attributable |
| Operating scope maintained | — | 50+ systems · 32,000 users · $15B transactions | Directly attributable (scope) |
What the transformation enabled: greater delivery predictability and capacity gave TES the ability to scale teams, absorb increased workload, and make faster, better-informed delivery decisions — improving its competitive position in a demanding market.
Key success factors
- Leadership: hands-on direction that aligned the technology transformation with business strategy and built a culture of continuous improvement.
- Comprehensive training: broad SAFe training embedded agile principles across all teams rather than in isolated pockets.
- Cultural shift: the change was about people as much as process — building trust, transparency, and shared purpose.
Conclusion
The SAFe adoption at Change Healthcare TES, led by Michael Renna, stands as a model for large-scale agile transformation in healthcare technology. It moved release predictability from 68% to 96% in six months, embedded agile practice across the organization through broad training and leadership modeling, and modernized the infrastructure underpinning ~$1B in annual revenue with zero disruption to systems serving 32,000 users. The result demonstrates the impact of aligning delivery transformation and infrastructure modernization under focused technical leadership.