Healthcare organizations across the spectrum are tapping digitally-enabled solutions to improve the cost and quality of care as they journey from volume to value. EXL combines unmatched healthcare domain expertise with data-driven insights and digital technology to transform how care is delivered, managed and paid. This ensures our clients achieve high-quality, effective healthcare at an appropriate cost.

EXL’s digitally-enabled transformation solutions orchestrate innovation, automation and performance excellence to impact payment accuracies, cost management, quality outcomes, and appropriate utilization.

Here’s how we help:

Value-Added Capacity

Domain expertise infused with intelligence to drive meaningful outcomes

Technology and AnalyticEnabled Solutions

Digital and technology platforms informed by analytics and driven by automation for a unique 360° data view

Insights and Advisory Services

A consultative approach to pinpoint precise recommendations, prescribe actions, and operationalize insights

With a diverse client base, we solve business problems from a multi-dimensional perspective

  • Payers: Supporting payers in decreasing administrative waste, reducing overall health claim expenditures, and optimizing revenue opportunities while improving member care quality, network performance and managing population risk
  • Pharmacy Benefit Managers (PBMs): Helping PBMs to manage member drug benefits and reduce drug-spend expenditures without sacrificing quality
  • Providers: Enabling provider organizations to proactively manage risk, improve quality outcomes and optimize network performance
  • Life Sciences: Providing pharmaceutical, biotech and medical device companies with enriched data, data management expertise and advanced analytics to obtain value-based excellence

Covering more than 150 million lives, EXL partners with healthcare organizations to offer an array of services that offer insights, improve processes and deliver outcomes

CLINICAL SERVICES

EXL’s end-to-end clinical services and solutions support an integrated model to achieving efficient, effective and compliant operations. Our team of deep domain experts looks to advanced analytics, sophisticated technology and digital innovation and automation to help improve quality and efficiencies, drive effectiveness and deliver impacts on member health, network performance, cost, quality and utilization outcomes.

  • Case management and utilization management
  • Population and risk management
  • Integrated care management platform
  • Clinical innovation and automation
  • Program and outcomes analysis

PAYMENT SERVICES

EXL’s payment services include comprehensive reimbursement initiatives that help payers and providers control costs, reduce overall health claim expenditures and optimize revenue opportunities while improving provider experience. We produce actionable insights at every touchpoint along the payment continuum.

  • Pre-pay and post-pay audit solutions
    • Claims auditing
    • Data mining
    • Subrogation
  • Payment and fraud, waste and abuse analytics
  • Provider experience
  • Payment capacity and payment transformation services

DATA & ANALYTICS SERVICES

Leveraging our data assets, advanced analytics capabilities and subject matter expertise, we offer packaged and customized analytics services that help clients identify, optimize, create, capture, and grow business value.

  • Data assets, claims benchmark and consumer data
  • Data discovery, visualization and data platform
  • Data engineering, enrichment and management services
  • Advanced predictive and prescriptive analytics

PHARMACY SERVICES

EXL’s pharmacy solutions deliver operational effectiveness and efficiencies for our clients. We empower pharmacy leaders to focus on what matters most–quality care gaps, operational efficiencies, cost containment, capacity growth, medication adherence, and appropriate medication utilization.

  • Pharmacy Utilization Management
  • Pharmacy Quality and Care Management
  • Payment Integrity for Rx Claims

LIFE SCIENCE SERVICES

By leveraging extensive patient-, consumer- and HCP-level data assets, advanced analytics and subject matter expertise, EXL provides real-world insights and value-based solutions.

  • Patient intelligence
  • Market access strategy development
  • Market effectiveness

EXL Health: A Recognized Leader

EXL takes a unique approach to delivering healthcare value. Our deep domain expertise, extensive technology- and analytics-enabled services and solutions uniquely positions us to deliver deeper value. We do this through what we call Digital Intelligence, the orchestration of domain and data, people and technology, to deliver breakthrough business outcomes.

EXL’s demonstrated value to healthcare clients and strong market leadership is recognized across the healthcare industry.

 

INDUSTRY RANKINGS AND RECOGNITION

 

ACCREDITATION AND CERTIFICATION

 

 

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