Predictive Analytics to Create Customer Wellness Management System

Discover how Oxford provided a real-time, interactive, optimized customer wellness management system.

INDUSTRY
Health Insurance Provider

SERVICES
Roadmap
Gap Assessment
Architecture
Program Management

SKILLS
IBM Unica
Predictive Analytics
Data Modeling
Business Analysis
Project Management

The Challenge
Our industry leading-client required a system that would provide customers with the ability to self-manage their own health through an interactive system interface. The client desired a real-time, interactive, optimized system that could provide accurate and preferred series of action for each individual. Our team was engaged to conduct an assessment, develop a roadmap, design an architecture, and manage the development of this system. The key objectives of this engagement were to:

• Define the gap between current customer interactions and the desired future state
• Evaluate existing technology to support analytic processes and interface decision optimization
• Establish metrics for system performance, efficacy and ROI
• Design system architecture to integrate multiple data sources, analytical and business processes
• Reduce overall claims expense while increasing wellness across the customer base
• Increase the overall experience, retention, loyalty and lifetime value of each customer

The Solution
We deployed a team consisting of Project Manager, Business Analyst, Technical Architect and Developers. Our team conducted in-depth interviews across the client’s business and technical interests to define the gap between the current customer’s wellness management and the desired end state. We managed a combined team of in-house and contracted developers and analysts to design, develop and implement the desired composite system. The system included the ability to collect, store and perform statistical analysis of historical data. It also constructed predictive models and rank alternative outcomes across different segments of customers. In addition, the system could develop specific business rules to optimize and prioritize recommended actions.

The Result
Our team successfully developed a system two months ahead of our client’s scheduled timeline and exceeded all SLA’s. The system enabled claims savings for our client in the first nine months of deployment in excess of $16 million. It also drove response time to inquiries to typically less than 700ms. Part of our team is still currently in place providing maintenance services to the system.