Leveraged Analytics to Drive 16% 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

• 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