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Healthcare Analytics Solution

Actionable insights to engage consumers, improve health and quality of care, and reduce costs

The Patient Protection and Affordable Care Act (PPACA) mandate and medical loss ratio (MLR), the threat of losing members when health insurance exchanges proliferate, etc., have challenged the health plans.

Healthcare Analytics Solution

Increased competition and the need to reduce administrative costs while enhancing member experience have necessitated a transformation across the payer value chain – including in sales and marketing, operations, care management, provider management, member management, IT, and finance and compliance. Competing on analytics using data-driven insights to formulate and implement strategies will be a major focus area for health plans and is expected to be one of the top investment areas for healthcare organizations.

Healthcare Analytics Solution from Infosys allows payers to accelerate their innovation agenda, differentiate their products and service, enhance customer experience, and achieve greater operational efficiency.

Our solution suite includes:

  • Accountable care Combines portals, dashboards and a comprehensive analytical platform to support end-to-end accountable care organization (ACO) management
  • Patient-centered medical home – Provides an end-to-end offering from care coordination till primary care physician (PCP) reimbursement and related performance analytics
  • Value-based benefit design – Demonstrates end-to-end capabilities for designing benefits with decision support capabilities, and return on investment prediction and monitoring
  • Care analytics – Employs analytics-driven insights to various aspects of care management
  • Member switchover – Provides member retention planning through analytics
  • Member liability estimator – Predicts the member's payment liabilities based on statistical analysis of historical data
  • ICD-10 neutrality analytics – Provides next-generation clinical and financial BI capabilities by discovering information needed to analyze and detect risks, trends and opportunities for neutralizing the impact of ICD-10 across the enterprise
  • Medical loss ratio – Supports MLR optimization as per the mandate, with configuration of cost bases
  • Provider network performance management – Measures and manages performance of provider and contracting processes, along with network adequacy assessment

The Infosys advantage

  • Customizable and modular: Cherry-pick modules with relevance to the business, and then seamlessly integrate and use them in silos or in combination, with no compromise on user experience. We provide ready-to-deploy reusable components and industry solutions for key business problems.
  • CoE with tool-agnostic data scientists and statisticians: Leverage modules to create an intelligent ecosystem consisting of health plan staff, members, providers, and brokers. Your enterprise becomes more agile and implements decisions based on real-time information.
  • Optimized operations: Utilize multiple operational models that enable flexible ramp up and ramp down.
  • Agile operations with end-to-end ownership of services: The service-oriented architecture (SOA ) and interoperability layer enables the IT team to effect changes without touching the base code or reuse for different purposes. This ensures end-to-end ownership from prescriptive consultation to enabling implementation services.
Related reading

Brochure

Healthcare Analytics

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