Case Study

Provider Data Mart

Non-Profit

We helped a non-profit managed care organization improve their data quality and accessibility by implementing a data mart strategy.


CLIENT’S CHALLENGE


Our client, a non-profit managed care organization, was challenged by managing their data and reporting:
  • Multiple data sources maintained by individual departments with no source of truth
  • No integrated, enterprise view of provider data
  • Inability to capture real-time changes to provider data
Failing a random federal regulatory audit spurred them to hire Impact Makers to help them create and implement a solution for their data.

OUR APPROACH


Impact Makers’ Data Analytics experts:
    • Instantiated a Data Mart to serve as the first step toward a Single Source of Truth for data across all their providers
  • Leveraged their deep understanding of healthcare industry tools and standards such as NPPES, Melissa data, and LexisNexis to validate provider information via automated APIs
  • Defined and implemented data quality and enrichment rules around address standardization, specialty codes, and state/DEA assignments​
  • Developed a migration plan to sunset various department-specific data cubes and marts with the new enterprise provider mart
  • Leveraged the new mart to centrally manage provider directories across the entire organization

SKILLS AND TECHNOLOGIES LEVERAGED



The Results

By utilizing Impact Makers’ expertise, our client was able to realize:
  • Maximized investment in reference data from LexisNexis and Melissa data​
  • Standardized provider data mart across four (4) Health plans and five (5) states, used to source both online and print versions of the Provider directory​
  • A 100% increase in auto-adjudication rates from 30% to 60%​
  • Reduced cost to produce online and print provider directories by 40%​
  • Increased member satisfaction and reduced provider abrasion