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GDS International - Next - Generation - Healthcare - Payers - Summit - US - 7


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Healthcare Payers Accelerate Business Performance with Sybase IQ Solution Brochure

Healthcare Payers Accelerate Business Performance with Sybase IQ Solution Brochure

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  • 1. solution brochureHealthcare Payers Accelerate BusinessPerformance with Sybase IQManage claims, manage costs, and meet mandateswith a complete view of the business Optional Photos Here (fill space)
  • 2. In today’s market, healthcare payers face unprecedented challenges. Customer demands have never been greater, regulatory pressures have never been more pervasive, and the products and services offered have never been more complex. To meet these conflicting challenges, insurance providers must be quicker, more responsive, and more flexible. To fail in any of these dimensions is to risk loss of business and ultimately market share to a competitor who is making headway in all three. Improving performance, and keeping strong performance on track, require a clear understanding of what is happening at every level of the business. Insurance providers must stay on top of revenue, sales performance, marketing effectiveness, and customer retention to strengthen the link between boardroom strategy andSolution features and frontline execution. Providers rely on accurate and precise plans, scorecards, reports, and dashboards to providebenefits at a glance up-to-the minute status on each of these key aspects of performance.• Consolidate multi-departmental To deliver on these demands, insurance providers need: performance management data in a centralized ‘single version of • A robust infrastructure that captures detailed data points that can be easily shared, provisioned, and the truth’ analytical repository understood• Slash fast growing consolidated • Timely access to prepared summary data, reports, and dashboards, providing a true measure of costs, data management costs by 40% profits, and other operational metrics to 60% using industry-leading data compression • Empowerment via analytical tools to enable analysis of various data dimensions at the speed of thought• Significantly increase Sybase IQ, the world’s leading column-based specialty server for data warehousing and analytics, is organizational agility and designed specifically to support sophisticated and complex queries and reporting. Its patented indexing and alignment with accurate, on-time, data compression technology ensure a smaller footprint than can be achieved with traditional solutions, and visually rich and highly responsive at a lower total cost of ownership. Its open approach to implementation and scalability means that Sybase IQ financial, operational, and claims is ready to accelerate performance in the environment that insurance providers already have, and to enable analysis dashboards and reports them to grow their solution as their business grows.• Roll out new metrics dashboards and scorecards linking strategies with execution-based, industry- standard metrics and logical data models2
  • 3. Used in conjunction with SAP® BusinessObjects portfolio, Sybase IQ enables a consolidated environmentfor analysis and decision-making, giving insurance providers the leverage they need to track and manageperformance. Here we examine how Sybase IQ can accelerate performance for Health Insurance payers. Health insurance payers are under heavy pressure from both consumers and the government to control “The divisions need to beescalating healthcare costs, reduce the ranks of the uninsured, and provide greater value to their members. able to run analysis on theirIncreased enrollment in managed care plans (including HMOs, PPOs, and POS plans) has been dramatic. own and customize them asConventional “fee-for-service” indemnity coverage, which was once essentially the universal model for health needed. To accomplish this, weinsurance, is quickly being supplanted by a vast number of options available to organizations and individuals need an IT system that is easyshopping for coverage. Meanwhile, the Patient Protection and Affordable Care Act (PPACA) and other to understand, flexible, andgovernment initiatives raise a host of new challenges for payers requiring ever-greater insight into processing above all, very fast.”claims, managing customer relationships, and controlling costs. Andreas Seibert, Head of IT-Business Department, AOK Hessen Accelerating access to and understanding of both claims and business operational data yields great value both tactical and strategic decision-making — how can a payer stay competitive, by finding new pools ofcustomers? Which payers can deliver the contracted coverage? Which payers deliver better outcomes for less?How can payers improve processes and reduce administrative costs? Succeeding in this complex and rapidlychanging business and regulatory climate requires being able to answer exactly these kinds of questions. “...speed, cost savings, low Health insurance payers demand timely and accurate reporting on several key dimensions of performance: maintenance... what more can you ask for?” • Product, service, and claims management metrics Duane Green, Vice President of • Effective customer acquisition and enrollment metrics Systems Operations, HealthTrans • Distributor relationship metrics • Cost management metrics • Profitability metricsAccelerating Business Performance for Health Insurance Payers with Sybase IQ Sybase IQ is the engine driving accelerated performance for many healthcare payers. Working closely withTriZetto® Facets® and other claims data sources, Sybase IQ routinely accelerates reporting performance by afactor of 200 times or more, enabling faster, more responsive, and better aligned business decisions. Typicalreports provided in these Sybase IQ environments include: • Daily claims queue and adjustments • Enrollment productivity • Due and unpaid premiums • Denied claims • Customer call by reason • Member services productivity • Daily open customer cases • Emergency room visits • High-cost procedures 3
  • 4. Additionally, Sybase IQ is part of an integrated ecosystem of technologies that support accelerated reporting performance for health insurance payers, including: • Sybase Industry Warehouse Studio™ for Health Insurers – Contains sample data, schema, scripts, and pre- built reports based on lessons learned from hands-on experience gained over many years in the health insurance industry • SAP BusinessObjects EIM Data Services – A versatile data movement technology suite that includes a Data Integrator ETL tool optimized for loading Sybase IQ from a variety of data sources combined with a robust data quality module • SAP BusinessObjects Enterprise Performance Management Suite – Provides insurers metrics to ensure sustained profitability through revenue growth and expense containment P E RFORMANC E WAR E HOU S E Administrative Which physicians Data have better outcomes and lower cost? DI S PARA T E DA T A S E T S Pharmacy Claims Data What lifestyle Physician and Facility behaviors increase Claims Data claim payments? Lab Test Results Socioeconomic Elements Sybase IQ Facets Data Sybase IQ brings disparate data together and serves as the heart of a high-performance analytics and reporting environment, delivering faster, more accurate, and more complete answers. In summary Sybase IQ has successfully supported many enterprise-wide reporting and performance management solutions worldwide in the Healthcare Insurance Industry and has brought transformational business value to the adopting Insurance firms that have clearly demonstrated: • Pivoting customer, claims, and operational data analysis across departmental boundaries • Timely, responsive, ad-hoc, and stage-by-stage reports across various functional rolesTo learn more about how Sybase IQ supportsaccelerated performance for insuranceproviders, and to see how Sybase IQ canaccelerate your company’s performance,please contact your Sybase salesrepresentative or call 1-800-8-SYBASE.Sybase, Inc.Worldwide HeadquartersOne Sybase DriveDublin, CA 94568-7902U.S.A1 800 8 sybase Copyright © 2011 Sybase, Inc. All rights reserved. Unpublished rights reserved under U.S. copyright laws. Sybase, the ® Sybase logo, and Industry Warehouse Studio are trademarks of Sybase, Inc. or its subsidiaries. indicates registration in the United States of America. SAP and the SAP logo are the trademarks or registered trademarks of SAP AG in Germany and in several other countries. All other trademarks are the property of their respective owners. 09/ TriZetto Facets is a registered trademark of The TriZetto Group, Inc.