FirstCare Health Plans Uses WebFOCUS to Manage Rapidly Growing Business
Company Size
1,000+
Region
- America
Country
- United States
Product
- WebFOCUS
- Visual Discovery
Tech Stack
- Business Intelligence
- Data Warehousing
- Data Visualization
Implementation Scale
- Enterprise-wide Deployment
Impact Metrics
- Customer Satisfaction
- Productivity Improvements
Technology Category
- Analytics & Modeling - Predictive Analytics
- Analytics & Modeling - Real Time Analytics
Applicable Industries
- Healthcare & Hospitals
Applicable Functions
- Business Operation
- Quality Assurance
Use Cases
- Predictive Maintenance
- Real-Time Location System (RTLS)
Services
- Data Science Services
- System Integration
About The Customer
FirstCare Health Plans is a healthcare provider that has been serving the healthcare coverage needs of members across North, West, and Central Texas since 1985. The organization offers a wide range of HMO, PPO, ASO, and ancillary products through a variety of programs, including small and large employer plans; state, federal and teacher plans; government programs; new private market plans; and the health insurance marketplace. The company is committed to providing access to high-quality, affordable healthcare.
The Challenge
FirstCare Health Plans was facing a challenge due to its reliance on two different claims systems and data warehouses, disparate reporting systems, and a lack of Key Performance Indicators (KPIs) for finance, in-patient care, sales, pharmacy, and other functional domains. The company was experiencing a growing volume of claims that required manual intervention due to the expansion of its membership with new plans for the Texas Health Insurance Exchange. The company was looking for a solution that would not require an increase in internal staff members to support the growing workload.
The Solution
FirstCare Health Plans implemented Information Builders’ WebFOCUS business intelligence (BI) analytics environment to streamline its healthcare reporting systems to meet government guidelines. The company used WebFOCUS to create BI dashboards reflecting current claims volume, revenue, membership, expenses, medical loss ratios, and other important variables. The BI team also created key performance indicators (KPIs) that tie annual goals to revenue, membership, and administrative expenses. By incorporating goals into the dashboard gauges, managers can see how their departments are performing in relation to those goals. Red, yellow, and green indicators help them spot trends at a glance. An executive summary provides a high-level view broken down by department.
Operational Impact
Quantitative Benefit
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