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Health. Advanced Health Analytics
How do you feel about big data?
Business case
This information may be kept unstructured, incomplete, and not verified. Moreover, when it comes to processing, you typically think of on-demand reports generated manually with no cross-functional component. And the focus of such reports lies within the consequences and not the root cause of the problem.
That is exactly where we started with our partner MEDGULF Saudi Arabia. MEDGULF is one of the leaders in the Insurance market of the country and takes much effort to enhance its processes, products, and client service. The Insurer has ambitions to become the leader of the KSA Market, and we feel this dedication in every step they take.
That is exactly where we started with our partner MEDGULF Saudi Arabia. MEDGULF is one of the leaders in the Insurance market of the country and takes much effort to enhance its processes, products, and client service. The Insurer has ambitions to become the leader of the KSA Market, and we feel this dedication in every step they take.
Data is one of the most valued assets of any insurance company. This statement has no doubt behind it. However, if you look at the big picture, you may find millions of insureds coming from thousands of corporate contracts with access to thousands of providers resulting in billions of claims.
publication date:
December 20, 2022
Tags:
Health insurance
Analytics
Business case
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Health insurance
Analytics
Business case
For weekly meetings, reports were prepared with a big time lag, and there were plenty of additional files available to go deeper into particular figures.
Evidently, it was not something a manager would like to work with on a daily basis.
Evidently, it was not something a manager would like to work with on a daily basis.
Baseline:
The first and biggest step of the project was Data Cleaning. We spent a few months bringing the data to a single format and enriching it with the missing information and classified data. The resulting step was the creation of an analytical data warehouse which would become a source for Power BI reports.
Project scope:
1
The next step was the creation of the report library – a complete and fully structured list of BI Reports to keep track of the company's target KPIs.
2
The final step was the organization of the smart circle approach between the sales, underwriting, actuarial, operations, and claims teams to take actions such as setting up the target inflation rate, changing a tariff for the network, moving clinics between networks, preparing clients for an upcoming tariff increase, discussing a possible program change with renewable clients, informing clients about unethical clinics and practices, sharing market trends and many more.
3
Implementation and moderation of the Smart Circle management decision methodology
Smart Circle
Fully automatic BI Reporting process based on the complete and fully structured report library
Report Library
Grouped Data from all main systems in one Database
Data Warehouse
Cleaned and preprocessed historical data with additional enrichment and classification
Data Cleaning
Result
The embedded BI platform allows working with the data from any angle and with any precision level while showing the interdependence between the factors. Here are some highlights to consider:
All these resulted in higher speed decision-making, only evidence-based judgment, and no bias on the data and indicators of the past.
3
The system allows a deep dive into any figure with one click, meaning one does not need to create tons of different reports anymore, while the link between figures is easily tracked.
2
Numbers and calculations appear with a minimum time lag from the moment the data was first received, which helps to see an up-to-date picture and any changes on the fly.
1
The data is structured in a way that the manager sees precisely the figures affiliated with their KPIs and can track the influencing factors and dynamics.
One of the most promising projects arising from BI Health Analytics is Portfolio Modelling: a portfolio simulator able to forecast management decisions with a two-year horizon. Based on historical figures, market factors, and future trends, the model can help build scenarios for various management decisions.
What’s next: