Overview

The healthcare industry faces one of the most overwhelming challenges today - improving healthcare delivery while reducing healthcare costs. A tough problem, and no simple solution. The answers however lie in the information held in millions of claims, lab data, HRA data, and pharmacy data exchanged by providers, payers, employers, PBMs, and other stakeholders exchange every day. Healthcare stakeholders have also realised this but face a serious challenge - how to efficiently and accurately assimilate, organise and consolidate this data and transform it into actionable information so that decision makers can figure out what’s working, what’s not and what needs to be done to improve processes and lower costs.

Key Information Challenges

  • Working with multiple platforms, data formats, data feeds, and data suppliers to get a holistic view of data
  • Building homogeneous data warehouses for claims, care management, overpayments, and actuarial purposes
  • Data is often stored and used in silos
  • Leveraging the information in the data requires both healthcare and IT expertise
  • Leveraging data so that internal applications can be deployed across the organisation - e.g. Reporting, Analytics, Fraud and Abuse, Care Analytics, Membership, Contracting Analytics, Provider Network Analytics

Value Proposition

At the heart of all our services is our ability to consolidate and transform vast healthcare data. We have deep experience in managing multiple data feeds including claims, pharmacy, lab, HRA, and care management AND transforming these data into homogeneous high-performance databases for claims, care analytics, cost management, contracting, and network management. In addition to working extensively with data, we have deep client experience working with national plans, regional plans, and small health plans including Blues and commercial carriers; Pharmacy Benefit Managers; Care Management vendors; and Integrators.

Our Solution

We work collaboratively with clients to understand their data needs. As a premier service provider of healthcare cost management solutions, we understand both the IT and Business User perspectives and have built robust tools and processes to help clients consolidate and leverage their data. To learn more about how SCIOinspire can help your organisation further leverage your data to improve claims processing, care management performance, employer reporting, and MIS reporting, please write to us at marketing@scioinspire.com