Using IBM Cognos performance management and business intelligence, health plans can reduce costs, drive operational and financial efficiencies, monitor and act on key metrics, and provide high-quality service to customers. More specifically, IBM Cognos helps health plans:
Improve customer service, satisfaction and profitability
- Access a single view of members and providers for service, sales and risk purposes
- Identify most profitable services, products and markets
- Provide self-service reporting and analysis to employers and providers
- Support transparency and quality reporting to members and consumers
Enhance operational efficiency
- Gain a single view of business performance
- Increase the quality of decisions by providing more accurate, timely reporting
- Manage multiple reporting and consolidation standards
- Reduce operational and IT costs by providing self-service reporting and analysis to customers
- Provide timely, consolidated monitoring, analysis and planning of internal operations
Improve clinical efficiency, quality, and medical cost management
- Enable population analysis, quality and wellness programs
- Support disease and case management initiatives, pay-for-performance programs and clinical research
- Identify and manage trends in treatments, quality, provider performance and clinical quality
- Model scenarios for disease profiling, spotting predictive events and supporting prevention initiatives
Manage and reduce risk
- Understand, control and balance risk position against potential revenue
- Comply with regulatory requirements such as data retention and provisioning
- Analyze and model risk patterns and events to identify and minimize fraud
