How we helped a mid-size employer drive cost saving opportunities to the tune of $250k+ within 4 months of solution implementation

healthcare analytics companies

Client Situation

Client description
  • The customer was a mid-size organization who were working with a TPA to manage the health insurance for their sizeable population of employees and dependent members.
Challenge
  • Client approached us to help them identify the drivers of high healthcare cost and develop a sustainable solution to manage and monitor it effectively in future
Objectives
  • Provide a centralized pre-launch planning tool managed by the brand team and accessed by functional teams- sales, marketing, access, distribution- to track, understand and inform a holistic brand launch strategy formulation

D-Cube Approach

Implementation of the DDS HealthEX module:
  • Step 1: Integrated multiple sources of claims data, internal HRA files, Rx Data, Direct Contract and Direct contract aggregator data
  • Step 2: Identified the high cost items and evaluated the potential options to bring the cost down
  • Step 3: Designed & deployed a series of executive & business user level dashboards & composite models to monitor the cost in future as well as provide actionable insights for keeping the healthcare cost down in future

Client Impact

  • Avoidable ER Visits – We noticed that 40% of ER visits were for the disease conditions that does not require ER resulting in ~60K of unnecessary expenditure. We recommended to educate the employees about ER usage and increase Copay for ER visits
  • Generic Utilization – We noticed that 25% of chronic medication can be replaced by Generic medicine that will result in ~100K of savings
  • Low Utilization of Low Cost healthcare providers – We identified low cost healthcare providers for top medical procedures and asked employer to guide the employees to utilize them. This had a potential of saving more than 100K over a 12 month period