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Datasource partners with top healthcare provider to implement a comprehensive Data and Analytics Excellence program to manage all insurance claim activity, approximately $1 billion in costs managed annually.

Client Background

This leading healthcare provider has more than 550,000 members across Colorado.

As one of Colorado’s premier healthcare providers, this organization is committed to giving patients access to top physicians as well as quality, customized care options. Serving this mission requires the collection of a tremendous amount of data. Data assets collected include everything from insurance claims, patient records, and cost of care reports.

The Datasource Solution

Looking for a new way forward, the organization turned to Datasource for a complete Business Intelligence (BI) solution. After an assessment of the enterprise and its data management requirements, the organization selected a comprehensive Data and Analytics Excellence (DAE) program.

Datasource consultants developed a business case to map out required resources and personnel commitments for the project. They also outlined the potential impacts of the data management and BI program.

The Roadmap

Program Assessments
The organization’s board of governors created three teams to work in parallel with the provider’s initiatives: Governance, Technology and Architecture, and Change Management. Business owners were assigned to manage data assets and define strategies for data integration solutions.

Data Architecture Development
In addition to an inventory of data models for applications, Datasource employed standards and proven methodologies to capture business requirements and translate those into an integrated data environment.

Change Management
Datasource restructured analytics roles and defined better communication channels for analysts. Datasource also improved processes for validating how information is sourced, analyzed, and delivered to information consumers.

Implementations & Customization
Datasource implemented customized BI tools with smarter reporting and analytics. We also identified data needs, integrated the right data, and created customized reports. Analytics now go beyond the collection of metadata to include a broader insight into the business.

The Results

Today the organization’s DAE now manages all insurance claim activity as well as substantial data assets across the organization; this equates to approximately $1 billion in annual costs managed through the system. Because all activity now filters through a single data management solution, leaders can effectively manage the cost of care compared to impacts from financial, operational, and clinical perspectives.

This DAE deployment, including training, change management, and the data stewardship program, were completed on time and with an extremely positive response. Today, the organization has new data management policies in place for more targeted reporting and analysis, all based on the best practices implemented. The team is leading the way in meeting its goal to deliver superior care and a customized patient experience.

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