• Assess the effectiveness of your current plan design and recommend changes based on the outcome
• Evaluate the ROI of various wellness and health programs
• Drive your health programs leveraging insights from cutting-edge technologies such as process mining, machine learning and artificial intelligence. Examples of such analysis include:
  • Mapping the clinical journeys of members
  • Identifying and coordinating care for members suffering from chronic conditions
  • Predicting the next disease / diagnosis conditions that members may suffer from
  • Assessing the adherence to prescription drugs and medical treatments by members

• Assess and improve operations effectiveness of business areas such as underwriting, claims processing, etc.
• Reduce fraud, waste, and abuse (FW&A)
• Evaluate and improve the effectiveness of customer engagement and experience throughout customer lifecycle: from onboarding to claims to renewals

• Improve quality of care and achieve better patient outcomes using insights from advanced machine learning and AI algorithms
• Reduce cost of operations through effective utilization of the existing infrastructure and resources
• Set, track and evaluate physicians’ goals and performance

Our deep understanding of the healthcare domain, creative problem-solving approach, and ability to connect data across disparate sources allow us to deliver targeted analytical solutions that drive actions for better outcomes.

• “X-Ray” the Operations: we do a thorough current state assessment to build transparent views of the process such as patient journey, areas of concentration of FW&A, etc. and segment population by key areas of interest such as place of service, diagnosis conditions, provider type and others
• Discover Opportunities: using the outcome of the “X-Ray”, we identify key challenges and areas with high potential impact to drive further action
• Improve Outcomes: for the identified areas, we then design and recommend appropriate plan design changes, build and deploy advanced analytical models, and put in place mechanisms for ongoing performance monitoring