The Client

A large, national specialty/retail healthcare organization needed data integration, analytic support, and outcomes reporting in order to launch 3 ACOs within a short period of time.

Client’s Challenges

  • Needed advanced descriptive and predictive clinical and financial outcomes reporting
  • Needed to build a large and effective team to support analytic and reporting objectives
  • Needed predictive models to proactively engage with members regarding their health decisions
  • Needed an integrated data warehouse to support analytics and care coordination efforts

EXL’s Solutions

  • Developed a comprehensive reporting package to demonstrate program outcomes and identify areas of opportunity
  • Provided a team of senior researchers, data engineers and health analysts to work as an extension of the client’s informatics and analytics teams
  • Continue to deliver a monthly integrated member profile to the client, utilizing claims, lab/biometric, and EMR data sources

Results

  • Built a flexible delivery model to support the client on continuous and ad hoc analytics requests
  • Delivered an interactive reporting suite to provide actionable results
  • Operationalized risk models allowing clinical teams to design outreach strategies

Business Value

  • The ACO has the ability to demonstrate required improvements in member compliance of high value services, to drive savings and provider incentives

Analytics Model

  • ACO analytics
  • Economic modeling
  • Data management

Engagement Model

  • Staff resourcing
  • ID/Stratification
  • Reporting

Technology / Platform

  • SCIOVantage Platform


Written by EXL Health Team

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