Health Plan Analytics via Platform-Based Services

A faster, better way to health plan analytics is just around the corner

As a health plan executive, you are tasked with providing data-driven, actionable insights to drive decisions. However, your enterprise data is fragmented and technology limitations do not allow you to harness the power of your most important asset – data. That is where West Monroe excels—harnessing the power of technology and data to accelerate the delivery of actionable insights. 

We offer an undeniably different approach that allows us to generate targeted insights in days or weeks rather than months—and at a fraction of the cost of traditional analytics solutions.  

Our analytics offering via Platform-based Services allows health plans to envision, plan, and activate strategies to deliver actionable insights that improve targeted outcomes. To achieve this, we accelerate the ingestion of healthcare-related datasets, provide a way to store the data (while preserving interrelationships), and curate data subsets with data-science capabilities targeted toward specific business problems (e.g., Medicare Advantage Stars, care management, and medical expense management). Our underlying platform, Intellio® DataOps, automates the complexities of aggregating data from multiple sources and preparing it for analysis. That means you can get right to work making insight-driven decisions that help you manage medical and administrative costs leading to a better managed Medical Loss Ratio. 

Take advantage of out-of-the-box functionality built specifically for health plans:

  • Standards-based data ingestion (e.g., FHIR, HL7, EDI) to accelerate data ingestion processes 
  • Health plan-specific canonical data models for key domains (e.g., claims, clinical, Rx, SDoH) that preserve data integrity and fidelity 
  • Established sets of foundational benchmarks—including attribution, risk-adjustment, segmentation, grouper capabilities, CMS metric projections, and segmentation--available across business functions  
  • Continuous integration and delivery pipelines for DevOps (CI/CD) to accelerate development and foster a “innovation-to-production” culture
Get to insights faster with Intellio® DataOps

 

West Monroe’s Health Plan Analytics offering is powered by Intellio® DataOps, which ingests data rapidly—from multiple sources—and prepares it for analysis. The result? You get faster and more valuable data-driven insights to help you manage medical and administrative costs, leading to a better medical loss ratio.  

Learn more about West Monroe’s Intellio® suite of assets that deliver results, faster.

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Results You Can Expect 

  • Accelerated development of targeted insights, decreasing time-to-value 
  • A unified “data to value” delivery platform 
  • An innovation sandbox that can be easily turned into a product 
  • Reusability and consistency of cross-functional components 
  • Better-managed medical and administrative costs 

What We Offer 

Envision improvement 

We start by working with you to assess your capabilities based on alignment to strategy and identify gaps across four key areas: data, technology, operating model, and skills and organization. This enables us to identify the most critical business problems on which to focus.

Plan your course 

Our approach focuses on value and business outcomes. So, we’ll help you prioritize capability gaps based on value and effort – and then build a roadmap and plan to address them by using new data and analytics capabilities. 

Activate your insights 

Now, we will use our platform and data science capabilities to address targeted decision support reports or insight needs to address specific business challenges, such as provider performance, high-cost claims, or quality (MA Stars, NCQA). Together, we’ll build hypotheses and then conduct quick experiments until you see results.

Operate based on fact 

As your organization recognizes and harnesses the power of data, you can begin to embed this approach into your ongoing decision workflow and/or vendor partnerships. This will enable you to continuously measure performance, close clinical gaps, and realize value through cost efficiency and growth. 

Want to learn more?