Leveraged Analytics to Drive Increase in Contribution Margin for Medicare/Medicaid Provider

Challenge

A provider of dual Medicare/Medicaid eligibility services was unintentionally eliminating eligible potential enrollees. The company sought to optimize outreach and enrollment processes to profitably maximize revenue yield.

Approach

The SSA & Company team deployed an Economic Activity Analysis to map and measure the operational and economic value of enrollment activities. We used advanced analytics techniques to mine and map activity workflow volumes and conversion probabilities created a marginal cost model that identified the point where outreach efforts became unprofitable, and uncovered that strategic process & policy changes could decrease the current cost per approval and shift the cost curve to allow for deeper mining of the member population at a lower cost.