EXL’s operations teams, analytics experts, and care management technologies place us in a unique position to offer integrated and modular solutions to the healthcare industry. These capabilities provide innovative insights and strategies to manage the clinical, financial, quality and performance issues in today’s healthcare reform environment. Through integrated program design based on extensive and credible healthcare experience, EXL provides its clients with the opportunities to optimize outcomes, reduce costs and enhance revenue.
Total Population Health Management 2.0 (TPHM 2.0) is our advanced approach designed to address the clinical and lifestyle management needs of an entire population. TPHM 2.0 provides the technology, analytics and care management competencies by which healthcare organizations can better know their customers, engage members to drive behavioral change, involve and align providers, and measure process and outcomes.
EXL has multiple accreditations with NCQA and URAC, including Utilization Management, Case Management and Disease Management Accreditations.
GLOBAL PROFESSIONALS IN CLINICAL, ANALYTICS & CONSULTING
PAYER CLIENTS, INCLUDING SIX OF LEADING TEN PLAYERS
MEMBERS ON EXL'S CARE MANAGEMENT PLATFORM
EXL is committed to providing the healthcare industry with the tools and clinical resources needed to enhance quality outcomes while achieving cost-effective delivery of care in a high-performance organizational environment.
With Precision Empowered Care Management® services (formerly Health Integrated), we enable health plans to precisely manage their most vulnerable members. By combining actionable big data with a proven biopsychosocial model, we address the physical, psychological and social drivers impacting member health and satisfaction. As a result, plans enhance quality, achieve compliance and strengthen their financial performance end-to-end, while empowering members to achieve better outcomes.
EXL deploys more than 1,200 clinical and healthcare administrative staff – including more than 500 U.S.-registered nurses. Our clinical operations support services include a wide range of care and pharmacy management services as well as programs in short term/long term disability and workers compensation. EXL also offers a suite of payment integrity capabilities, revenue optimization (HEDIS programs), medical record summarization, as well as provider services such as billing support and member enrollment.
EXL’s healthcare analytics group provides a wide range of solutions to enable better clinical decision-making, improve member care, manage risk and drive better market access. Our award-winning data scientists and analytics experts enable market leading, next-generation care management decision support, patient-centered and consumer-centric health models, and actionable insights to drive higher efficiencies and cost containment.
The suite of products offered through Population Health Solutions (formerly EXL Landa) is pivotal to improving performance/productivity, health status and revenue optimization. The flagship CareRadius platform integrates data from multiple sources and shares it among health plans, practitioners and members in real time. Its holistic view of the member enables personalized care plans, the ability to make timely decisions and plan earlier interventions to improve health outcomes.
“EXL has the capabilities to address the major factors impacting the quality and cost of care delivery in the healthcare reform environment.”
---- Dr. Jerry Osband (Chief Medical Officer) EXL
Through a combination of general, object-based and customized training, the EXL Healthcare Capability Development Center of Excellence offers training on Healthcare domains, techno-functional capabilities, soft skills, best practices and operations management.
In Everest Group’s “Healthcare Payer BPO - Service Provider Landscape with PEAK MatrixTM Assessment” (2018)
In Everest Group’s “Healthcare Provider BPO - Service Provider Landscape with PEAK MatrixTM Assessment” (2017)
In “IDC MarketScape: U.S. Healthcare Clinical and Financial Analytic BPO Services 2017 Vendor Assessment”
In “HfS Blueprint Report: Healthcare Business Operations Services” (2017)
In Everest Group’s “Healthcare Payer BPO - Service Provider Landscape with PEAK MatrixTM Assessment” (2017)
NelsonHall’s “Healthcare Payer NEAT” (2016)
"HfS Blueprint Report: 2016 Population Health and Care Management Business Services"
"HfS Blueprint for Healthcare Payer Operations 2015"
Top 5 Company by Industry Focus - Healthcare
International Association of Outsourcing Professionals (2014)
URAC HUM accredited