Healthcare's Most Pressing Challenges

Payers, Providers, Pharmacy Benefit Managers, and Life Sciences companies face three key, intertwined challenges when it comes to improving how care is delivered, managed, and paid.

Unprecedented disruptions and constant change in coverages, networks, and behavior.

Vast amount of data that needs to be aggregated and analyzed to improve outcomes.

The need to remain nimble and adapt quickly to changing market forces.

We Look and Go Deeper

Advanced analytics and cutting-edge technology are essential to solving today’s complex healthcare challenges. It also takes Human Ingenuity — the ability and willingness to look and go deeper to find a better way — to drive true success.

EXL Health is what it is today because of our unwavering commitment to doing what’s right to help our clients deliver the best healthcare outcomes. We believe in the power of Human Ingenuity – our innate ability to work alongside our clients to create solutions for their most complex problems.

Unprecedented disruptions and constant change in coverages, networks, and behavior.

Human Ingenuity in Action: Multiple Sclerosis patient analytics

A Life Sciences client wanted to identity the attributes of Multiple Sclerosis patients who dropped out of treatment vs. those patients who adhered to care plans.

Our team deployed several statistical regression/machine learning algorithms that helped identify these patients. As part of the approach, we created a decision tree that visually displayed what patient attributes were correlated to staying on therapy. This enabled our client to understand the complex nature of the underlying analysis in an easy-to-understand design.

Vast amount of data that needs to be aggregated and analyzed to improve outcomes.

Human Ingenuity in Action: Improved ability to identify fraud and abuse

Our client, a large U.S. health insurer, had a team that was running manual reports in multiple data sources to find fraud and abuse outliers that required further review. The process was labor- intensive and time-consuming, putting our client at risk for making inaccurate payments before fraud and abuse could be identified. We knew there had to be a simpler way.

Our team created a view that pulls all the required summarizations from claims, member, and provider data to evaluate potential issues. The report can be easily shared with other parties assisting with the investigation. By automating the process, we eliminated the need for four full-time employees to manually create reports.

The need to remain nimble and adapt quickly to changing market forces.

Human Ingenuity in Action: Real time, natural language processing (NLP) framework in weeks

Our Provider client needed to extract medical referral requests from free form text and needed to fully automate the end to end process. Our team had one month to figure out how to accept as many as 20,000 documents per day, run them through our NLP algorithm, and return structured data into our care management system for scheduling.

We saw that the project’s requirements weren’t much different than the needs of the systems that are at the core of our Care Management application. So we developed a scaled-down implementation that effectively applied well understood design principles in that domain to this project.

The resulting back-end application successfully routed requests as required, plus far more. We developed real-time monitoring so that if any request was slow, or if extracted data was not of sufficient quality, or if any request failed, the system stops processing and notifies operators to fix the problem.

Our team’s ingenuity took a project that could have been a one-off and made it the central blueprint for the continuous improvements we are making in our NLP offerings.

Human Ingenuity enables us to:

  • Be nimble, resourceful, and responsive.
  • Take the long view and invest in lasting customer relationships.
  • Build resilient models and services that enable lasting performance.
  • Orchestrate intelligence, analytics, and complex technologies that generate actionable insights and solutions.

By combining Human Ingenuity with cutting edge technology, we deliver real results to our clients.

  • Results that close gaps in care.
  • Results that improve payment accuracy.
  • Results that deliver insights for improved outcomes.
  • Results that get the right therapy to the right patient at the right time.

The Power of Human Ingenuity

None of these solutions would have been possible without using Human Ingenuity. It’s the catalyst for everything we do.

At EXL Health, we thrive on relentlessly innovating to help our clients transform their businesses. We are committed to working closely with our clients, looking and going deeper to find a better way.

Together, we will do this.

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