INTEGRATED DATA WAREHOUSING AND ANALYTICS: PROVIDING A SINGLE SOURCE OF TRUTH FOR A SELF-INSURED EMPLOYER

USE CASE

© EXL Service, Inc. All rights reserved.

EXLSERVICE.COM

USE CASE

INTEGRATED DATA WAREHOUSING AND ANALYTICS: PROVIDING A SINGLE SOURCE OF TRUTH FOR A SELF-INSURED EMPLOYER

Client

Our client is a global, multi-billion dollar, multi-industry company with over 30,000 employees. Its network of businesses produces advanced aviation,

defense and industrial products.

Client Need/Challenges

Being a self-insured plan sponsor, our client takes on the financial

risk of providing certain healthcare benefits for its employee and

dependent population. In order to support the costs that are associated

with being a self-funded employer, the company was looking to expand

its analytical capabilities to:

• Project healthcare expenditures for its employees to ensure

appropriate funds are earmarked

• Propose ideal healthcare benefit structures that accommodate

employee needs and Affordable Care Act (ACA) standards

• Determine appropriate employee payroll contributions and

suggest modifications based on expected future cost increase

• Identify appropriate medical management programs or

intervention strategies that help ensure a healthy productive

workforce while reducing total cost of care

• Develop strategies to reduce overall cost of healthcare

In summary, the company was looking for an integrated data

warehouse, as well as a reporting and analytics platform solution with

self-service capabilities to assist its Finance and HR Benefit teams.

In order to be able to conduct such analytical studies, the company

needed to overcome a number of challenges.

• Acquiring and aggregating data from its carriers

• Creating a fully integrated clinical data warehouse across all of its

business units

• Enriching its data warehouse with clinical and predictive analytics

• Providing its benefit analysts the ability to access this enriched

data warehouse and supplying them with pre-defined reports on

its member population

• Finding a partner with the knowledge and expertise required to

enrich its data from a clinical and analytical perspective

2EXLSERVICE.COM © EXL Service, Inc. All rights reserved.

INTEGRATED DATA WAREHOUSING AND ANALYTICS: PROVIDING A SINGLE SOURCE OF TRUTH FOR A SELF-INSURED EMPLOYER

EXL Healthcare Solution Approach/Methodology

EXL Healthcare designed a three-pronged approach to addressing the client’s needs and challenges.

Data Acquisition

Our team will work with the client’s third-party vendors to coordinate the file layouts, file feeds, testing, and approvals between and among the client,

its data vendors and EXL Healthcare.

Data Warehousing

We will provide data integration and warehousing services for initial implementation in coordination with the client.

Access to and use of the SCIOVantage® Analytics and Reporting Platform

Our web-hosted analytics platform, deployed for client, will include the following features:

• Clinical Definition Module: includes our Disease Identification, Facts, Measures and Indication modules implemented with our standard

definitions.

• Member Analytics Module: provides client users the ability to search for members using various parameters, as well as a Member 360 degree

view.

• Predictive Models: includes Financial Risk Models and Impactability Models.

• Standard Reporting Package: featuring multiple user-friendly dashboards, the following report types are included:

o Population Reporting: includes a series of standard population reports, including HEDIS measures reporting.

o Financial Reporting: includes financial trend and analytics reports that provide users with a line of sight on key cost centers.

o Outcome Reporting: includes a standard set of outcome reports, as well as an advanced outcome reporting module with the ability to

upload program participation data to generate self-service reports.

The EXL Healthcare solution also includes the following:

POWER USER ACCESS LICENSEA specific access license for SCIOVantage® and the reporting base. This license includes the ability for “power users” to

develop and deploy custom reporting packages, as well as perform ad-hoc analysis. This analysis is enabled through

access to the client’s data warehouse using our report building tool and SQL database access. In addition, these users

will have access to our SSH File Transfer Protocol (SFTP) to transfer data as required.

DATA REFRESHESWe will provide a monthly ongoing production refresh subject to data receipt before a mutually agreed upon cut-off

date from each eligibility, medical and pharmacy data source, per agreed upon schedules with each data source.

ACCESS TO EXL HEALTHCARE’S BENCHMARK DATABASEEnables comparative analysis relative to populations external to the client. This commercial benchmark dataset is

provided via the SCIOVantage® platform as part of our standard reports, as well as a separate member month level

extract for the client’s ad-hoc analysis.

BENEFIT MODELINGWe will build out a Basic Benefit model that will allow the client’s users, with Standard access to the SCIOVantage

application, to tweak the input parameters (e.g., benefit structure, payrolls, medical trends, etc.) and to generate a

pre-defined set of standard reports. Additionally the client’s users, with Power User access, will also be able to access

the underlying data that is generated from the model run if required for additional ad-hoc analysis.

3EXLSERVICE.COM © EXL Service, Inc. All rights reserved.

EXLSERVICE.COM

INTEGRATED DATA WAREHOUSING AND ANALYTICS: PROVIDING A SINGLE SOURCE OF TRUTH FOR A SELF-INSURED EMPLOYER

EXL (NASDAQ: EXLS) is a leading operations management and analytics company that helps our clients build and grow sustainable businesses. By orchestrating our domain expertise, data, analytics and digital technology, we look deeper to design and manage agile, customer-centric operating models to improve global operations, drive profitability, enhance customer satisfaction, increase data-driven insights, and manage risk and compliance. Headquartered in New York, EXL has more than 32,600+ professionals in locations throughout the United States, the UK, Europe, India, the Philippines, Colombia, Australia and South Africa. EXL serves multiple industries including insurance, healthcare, banking and financial services, utilities, travel, transportation and logistics, media and retail, among others.

For more information, visit www.exlservice.com

Share ShareTweet

To find out more about how EXL uses Digital Intelligence to help companies transform, contact us.

Anticipated ResultsThe client chose our data aggregation, warehousing, analytics and reporting solutions to recognize the following anticipated outcomes.

• Identify highly prevalent conditions and choose appropriate Medical management programs for its employee and dependency population

• Close gaps in member care, thereby improving overall health quality and potentially increasing productivity

QUALITYImproving Lifestyles for Employee Populations

• Develop strategies to help reduce costs generated by typical High Cost Claimants

• Identify potentially avoidable ED usage, and educate members about usage of Urgent Care centers

• Negotiate payment contracts for services utilized by members • Evaluate the effectiveness of the Medical management programs the client

has chosen to implement by measuring the population who participated in the program (participants) in contrast to members who did not participant in a program (non-participants) and assess cost, utilization, quality, and eventual ROI of the program

FINANCIAL Helping Reduce Total Cost of Care

• Project necessary financial reserves required to cover incurred claims • Project cost budgets for upcoming year in order to evaluate benefit design • Evaluate financial impact of different plan designs before choosing one • Report on monthly, quarterly and annual financial metrics required by

management

OPERATIONALEnsuring Appropriate Funds to

Support Self-insured Framework

• Provide a single source of truth – its aggregated and warehoused data – for analyst groups within finance and HR benefit management, enabled by a single partner in handling data aggregation, data management and analytics.

TIME SAVINGS Data and Vendor Management

© EXL Service, Inc. All rights reserved.