Healthcare

TEG offers a suite of Healthcare Data Analytics solutions to help you make better business decisions

Leverage our deep industry experience, proven analytic prowess and global delivery model

Look Backward

Product Impact Analysis

Analyze and recommend the important product attributes and their importance

Profitability Assessment

Assess profitable divisions, locations facilities for a provider/ insurer

Marketing Impact Analysis

Analyze Marketing effectiveness & efficiency and recommend marketing reallocation

Campaign Measurement

Measure Campaigns’ effectiveness: Identify & recommend successful messaging strategies

Patient Segmentation

Patient Segments that are relevant,meaningful, actionable & targetable

Claims Settlement Analysis

Detect Fraudulent claims, Generate Fraud Propensity scores and Optimize Claims

Look Forward

Product Design Analysis

Recommend product attributes based on anticipated competitive changes in a market

Marketing Optimization

Optimize and simulate the marketing activities to maximize ROI

Fraud, Waste & Abuse

Uncover unknown fraud schemes, predict and identify fraud activities

Payers/Insurers
Providers
Fiscal Organizations

TEG’s HealthWorks, an analytics solution powered by Tableau and publicly available HealthCare data

Helps payors predict in-market performance within five business days from the release of plans by CMS

Our expertise

  • 1

    Payors/Insurers
  • 2

    Providers
  • 3

    Fiscal Organisation

1. Payors/Insurers

TEG enables both the product and marketing organisations of payors with data science across the design, implementation, performance measurement and optimization stages.

Analytics Area Business Questions
Product Impact Analysis
  • What are the important product attributes driving enrollments of the insurance plans?
  • What percentage of the performance is impacted by the changes in product attributes from the previous year?
  • What are the common characteristics of top gaining/ losing plans in a market?
  • How can one profile exceptional plans in a market?
  • What attributes do the customers prefer?
Product Design Analysis
  • What are the important product attributes driving enrollments of the insurance products?
  • What is the elasticity associated to each of the product attributes in a market?
  • What kind of product changes could be anticipated from the competitors in a market?
Marketing Impact Analysis
  • How does one’s marketing activities drive enrollments of the insurance plans?
  • How effective and efficient are one’s marketing activities in a market?
  • How does marketing interplay with the product attributes in driving the enrollments in a market?
  • How can one develop an ability to predict in-market performance and in turn decide the required marketing dollars to be invested?
Marketing Optimization
  • Which marketing medium is contributing the most to the ROI?
  • How does one optimize the marketing spend across the multiple marketing channels?
  • How can one simulate various ‘what-if’ marketing spend scenarios and observe various outcomes before investing in a market?
Marketing Campaign Measurement
  • What is the effectiveness of the Direct & Digital mailing companies?
  • What is the cost of acquisition of a new member? How does this vary across demographic factors?
  • Which regions should one target more to get more conversions?
  • What sort of products, packages and creatives are well received by the prospects?
  • How should one message the product in a digital or direct mailer?

2. Providers

TEG facilitates access to huge volumes of integrated patient information and helps physicians/ providers in studying customer segments, optimizing services/facilities and effectively market.

Analytics Area Business Questions
Patient Segmentation
  • How can one segment the patients based on the demographics?
  • How can a provider utilize the above information to better staff and provide efficient facilities?
  • How should one collaborate with the insurance plans based on the demographic requirements of patients in the region?
Profitability Assessment
  • How can one identify profitable divisions and locations for medical facilities across geographies?
  • How does one provider’s facilities compete with the competitor networks?
Medical Record Data Management
  • How can a provider have access to patients’ past medical records?
  • How can one have easy access to patient claims data?
Marketing Optimization
  • Which marketing medium is contributing the most to the ROI?
  • How does one optimize the marketing spend across the multiple marketing channels?
  • How can one simulate various ‘what-if’ marketing spend scenarios and observe various outcomes before investing in a market?

3. Fiscal Organisation

TEG helps organizations monitor valid & fraudulent claims, optimize claim settlement process and predict fraud activities in advance.

Analytics Area Business Questions
Claims Settlement Analysis
  • How can one detect fraudulent claims using business rules and statistical analytics?
  • How can one optimize the Claims processes that includes activity optimization, payments optimization, etc.?
  • How can one develop a fraud-propensity score using the existing transactional data?
  • How can an insurer predict and identify the fraud activities before it impacts the business?
Fraud, Waste & Abuse (FWA)
  • How can one leverage the existing data to discover previously unknown fraud schemes?
  • Can one differentiate between the opportunistic fraud and the professional fraud?
  • How can one develop a fraud-propensity score using the existing transactional data?
  • How can an insurer predict and identify the fraud activities before it impacts the business?