With the total cost of Healthcare growing at an annual rate of 7 percent and expected to double between 2000 and 2010, the Insurance Industry is going through a unique period of change.
Increasing pressure from government regulations, the aging US population, demand for innovation and price pressures, the industry has no way out other than emphasizing on building sophisticated and innovative programs to contain costs and manage risk to remain competitive.
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- CASE STUDY
Insurance Claims Analytics to help identify application fraud
Market Equations helped a large insurance company in the United States develop an analytics based scoring engine that identified fraud and suspicious claims thereby, helping them take corrective action on a real time basis.
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- CASE STUDY
Medical Claims Analysis aimed at preventive care
Market Equations helps a large Insurance company in the US take preventive action by identifying individual members who have high probabilities of incurring high medical costs. Read More
Industry Trends:
Cost Containment
- Wellness programs, early diagnostics (prevention), low-cost testing, focus on innovative drug treatment versus surgery, and participation in HMOs.
- Passing higher cost burden to the insure - higher monthly premiums and co-pays
- Building Preferred provider Networks (PPN's) of physicians, clinics, hospitals, and pharmacies with pre-negotiated rates. Consumers are incentivized with low co-pays and fees when they use PPN's.
Customer Retention and Maximizing Profitability
- Intense competition, rapidly changing consumer demographics and demand, high acquisition costs necessitates the implementation of a well thought out strategy to remain competitive.
- Focus on accurate segmentation and effective use of the right communication channels using the right campaign management techniques is essential to maintain the lead.
- Understanding consumer demographics, key influencers that drive retention are required to ensure customer retention.
- Predicting Cross selling opportunities through Market Basket Analysis
Disease Management and Prevention Programs
Innovative programs focusing on prevention seems to be the order of the day.
- Investments on building mechanism that compare actual and predicted costs.
- Identifying members with high probabilities of incurring high medical costs.
- Building models that provide intelligence to take necessary action to prevent such happenings.
Case Study
Market Equations provided a unique solution to a large Insurance company in the US, working with huge volumes of consumer Medical data and customer demographics using logistic regression models to help them take preventive action by identifying individual members who have high probabilities of incurring high medical costs.
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Market Equations offers the following Solutions for your specific Industry:
- Customer Retention/Churn Detection
- Segmentation/Profiling
- Campaign Management
- Fraud Detection
- Market Basket Analysis
- Claims Analysis
- Disease Management/Forecasting
Market Equations offer customized solutions for the Insurance industry and works with medical claims data, member demographics and other information stored on large data warehouses, using SAS tools to build logistic regression models to compare actual and predicted costs, to identify individual members who have high probabilities of high medical costs, and various other ad-hoc analyses. The scope of our work goes beyond to also support a stream of new business initiatives brought to market by Insurance companies. Market Equations will assist you in uncovering the hidden truths from large chunks of existing data to deliver actionable intelligence that have an enduring impact and maximize profitability.
Market Equations can help you achieve substantial cost savings and manage high risk in this highly competitive industry. When you think everything is going against you, we can make the difference and help you maintain competitive advantage. Market Equations goes beyond promising cost efficiencies to working with you in understand your customers and business goals and objectives. We can help you build enduring customer loyalty and manage your risks effectively, on time.
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Analytics Outsourcing : Proven Analytics Outsourcing Tips
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