Healthcare

Driving measurable results for healthcare payers, providers and life science companies.

Reduce Costs

Improve Patient Outcomes

Implement Value-Based Care

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Ensure Compliance

Personalized Care

Are You Ready?

Healthcare is changing due to rapid advancements in technology, increasing consumer expectations, unparalleled access to data, and shifts in both regulation and reimbursement practices.

To stay competitive and improve outcomes, you must be able to efficiently deliver more affordable, effective healthcare – whether you are a payer, provider or life sciences company.

We Can Help

 Our experts deliver targeted strategy, data and technology solutions across the healthcare ecosystem to achieve new efficiencies and gain the insights necessary to improve outcomes and lives.

From IT modernization and process optimization, to data-driven business and technology planning, we can help you close efficiency gaps, transform the predictive value of data in clinical and business functions, enhance patient experiences and comply with ever-changing regulatory demands.

Solutions

Our team of experts can help you with:

Business Intelligence & Big Data

Leveraging emerging technology to identify data-driven improvements across the healthcare ecosystem.

  • Gain new levels of insight from structured and unstructured data sets
  • Create new service offerings and optimize speed-to-market
  • Improve member care and outcomes
  • Offer prescriptive, personalized medicine
  • Increase marketing effectiveness and channel alignment

Patient-to-Care Mapping & Management

Integrating various organ, population, RX and research data repositories to automate time and resource-sensitive care operations.

  • Implement function/model specific workflows
  • Create a “Match.com” prescriptive analytics interface with hospitals
  • Develop platform visibility and reporting across member and patient intersections

Data Science & Prescriptive Analytics

Diving deeper into historical, structured and new unstructured data to transform individualized care and improve the outcomes of patient journeys.

  • Increase the accuracy of care planning estimation
  • Cross-reference population data and claims history
  • Reduce costs and improve operational best practices
  • Develop population health and costing solutions
  • Increase membership

Healthcare Business Improvement

Combining policies, operational models, forward-looking strategies and technical infrastructures to deliver breakthrough financial performance and patient outcomes.

  • Reduce fraud, waste and abuse costs through business process optimization and advanced analytics
  • Utilize Agile principles for delivery
  • Develop and achieve IT and data governance

Claims Analytics & Adjudication

Investigating member claims and payment history to identify operational gaps and inaccuracies to increase financial performance.

  • Increase claims auto-adjudication
  • Optimize automated adjudication systems to reduce manual processing time
  • Improve accuracy by instituting claims processing best practices
  • Deliver engaging provider/patient portals
  • Leverage big data analytics to detect patterns in claims data

Quality Reporting, Provider Payments and Reimbursements

Improving the quality and outcomes of healthcare through end-to-end reporting capabilities and value-based care platforms.

  • Leverage E.H.R. data for quality reporting
  • Ensure compliance with healthcare IT standards
  • Improve HEDIS Measurement Scores through implementation of NextGen analytics
  • Increase value-based reimbursement through total cost of care fluency
  • Achieve compliance with SLAs with efficiency and issue alignment

The Perfect Partner To Fix Your Unique BPR Challenges

Healthcare

Financial Services

Education

Federal Employee Healthcare

With more than a decade of experience supporting the business and IT initiatives of Federal Employee Healthcare, our experts understand your unique regulatory, governance and security needs and challenges.

  • We have led and supported small and large scale projects that have been driven by changes in federal laws and mandates, adoption of next generation technology, reporting and audit requirements, and strategic planning.
  • We bring deep institutional knowledge in the frameworks, processes and expertise that is required to support the plan, build and run activities found in Federal Employee Healthcare organizations.
  • We can help navigate regulatory environments and provide expertise in security, reporting and governance.

We develop strategy for federally funded programs – as well as design, build and implement applications that host sensitive data.

Our Results Speak for Themselves

Saved Labor Hours

(in thousands)
Saved Labor Hours by Reducing 1,500,000 Claims from Manual Review Process

Incentive Payments Made

(in billions)
Incentive Payments Made to 500,000 Providers for Adopting Certified Electronic Health Records

Time Reduction

  • 56 Days
  • 2 Days

Time Reduction to Provide Data About Transplant Decisions

Members Supported

(in millions)
Members supported nationwide

Let’s Get Started