Client Impacts

Leveraged Analytics to Drive 16% Increase in Contribution Margin for Medicare/Medicaid Provider

Capabilities
Healthcare

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

  • Deployed Economic Activity Analysis to map and measure the operational and economic value of enrollment activities
  • Used advanced analytics technique to mine and map activity workflow volumes and conversion probabilities
  • Created a marginal cost model that identified the point where outreach efforts became unprofitable
  • 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

Results

I.

Developed a strategy for expanding operations, including with new, low-cost sources of labor in new geographies, to mine deeper into the customer pool and generate more profit than previously possible

II.

New strategy yielded 16% in incremental contribution margin for the organization with only a 3-month payback period

III.

Increased overall approvals by an additional 10%

Share

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