Case Studies Pyramid helps health plan provider put people first

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	Pyramid helps health plan provider put people first

Pyramid helps health plan provider put people first

Technology Category	Analytics & Modeling - Predictive Analytics Application Infrastructure & Middleware - Data Visualization Functional Applications - Enterprise Resource Planning Systems (ERP)
Applicable Industries	Healthcare & Hospitals
Applicable Functions	Business Operation Quality Assurance
Use Cases	Regulatory Compliance Monitoring
Services	System Integration Training
Challenge	Established in 2000 to provide affordable healthcare across eight South Florida counties, Community Care Plan (CCP) offers a wide range of health plans and local medical services to individuals and families. CCP is on a mission to promote healthier communities. To maintain the highest possible quality standards and regulatory requirements, CCP has relied on analytics and metrics to stay compliant and continually improve its services. Whether it’s more timely claim authorizations or matching services to individual needs, the aim is to deliver proactive and personalized health plans with a heart and a sense of community. Providing the business with the insights it needs to achieve its mission was proving difficult. Data was trapped in silos that made it hard to cross-correlate a member’s varying healthcare needs. Accessing claims details was taking too long because data sources were disconnected. Documents were manually entered into Excel spreadsheets or SAP Crystal Reports, and it was up to the IT department to manually compile the information that the various departments need. The goal for CCP was to see the full picture of individual members, as opposed to one metric in one silo. Implementing a more powerful BI and analytics platform became a priority. Read More
About Customer	Community Care Plan (CCP) is a healthcare provider established in 2000 to offer affordable healthcare services across eight South Florida counties. CCP provides a wide range of health plans and local medical services to individuals and families, aiming to promote healthier communities. The organization is committed to maintaining high-quality standards and meeting regulatory requirements through the use of analytics and metrics. CCP's mission is to deliver proactive and personalized health plans that cater to individual needs, ensuring a sense of community and care. The organization has been facing challenges in providing the necessary business insights due to data being trapped in silos, making it difficult to cross-correlate a member’s varying healthcare needs. Accessing claims details was time-consuming, and data sources were disconnected, requiring manual entry into Excel spreadsheets or SAP Crystal Reports. The IT department had to manually compile the information needed by various departments, making it challenging to see the full picture of individual members. Read More
Solution	In the early stages of Business Intelligence development, Leon Mink, Senior VP and CIO, and Alvaro Reis, VP of IT, evaluated several tools, including Tableau, before choosing the Pyramid Analytics platform. Although CCP is a Microsoft house, IT Director Terry Garzon found the drill-down capability of Pyramid superior to the Microsoft product. Having used Pyramid Analytics in a previous role, she was confident that it would be a good fit for the healthcare plan. She knew that Pyramid would make light work of consuming data from the Clarity databases that integrated with its health information system; that it could do the transformation that would enable data to be surfaced in reports for insights. An OLAP cube was created within an architecture primed for Pyramid functionality and the rapid analysis of data; 15 licenses were bought for users across the finance, claims, and pharmacy divisions. At the time, Pyramid was just launching the latest version of its product and spent two weeks with CCP, fine-tuning the platform’s functionality, aligning it to the health plan’s unique needs. Data was presented to stakeholders at the outset to make the business case clear. “The Pyramid team was excellent throughout,” said Terry Garzon, “and always willing to go the extra mile.” Read More Log in to view content
Contents

Technology Category

Analytics & Modeling - Predictive Analytics

Application Infrastructure & Middleware - Data Visualization

Functional Applications - Enterprise Resource Planning Systems (ERP)

Applicable Industries

Healthcare & Hospitals

Applicable Functions

Business Operation

Quality Assurance

Use Cases

Regulatory Compliance Monitoring

Services

System Integration

Training

Challenge

Established in 2000 to provide affordable healthcare across eight South Florida counties, Community Care Plan (CCP) offers a wide range of health plans and local medical services to individuals and families. CCP is on a mission to promote healthier communities. To maintain the highest possible quality standards and regulatory requirements, CCP has relied on analytics and metrics to stay compliant and continually improve its services. Whether it’s more timely claim authorizations or matching services to individual needs, the aim is to deliver proactive and personalized health plans with a heart and a sense of community. Providing the business with the insights it needs to achieve its mission was proving difficult. Data was trapped in silos that made it hard to cross-correlate a member’s varying healthcare needs. Accessing claims details was taking too long because data sources were disconnected. Documents were manually entered into Excel spreadsheets or SAP Crystal Reports, and it was up to the IT department to manually compile the information that the various departments need. The goal for CCP was to see the full picture of individual members, as opposed to one metric in one silo. Implementing a more powerful BI and analytics platform became a priority.

About Customer

Community Care Plan (CCP) is a healthcare provider established in 2000 to offer affordable healthcare services across eight South Florida counties. CCP provides a wide range of health plans and local medical services to individuals and families, aiming to promote healthier communities. The organization is committed to maintaining high-quality standards and meeting regulatory requirements through the use of analytics and metrics. CCP's mission is to deliver proactive and personalized health plans that cater to individual needs, ensuring a sense of community and care. The organization has been facing challenges in providing the necessary business insights due to data being trapped in silos, making it difficult to cross-correlate a member’s varying healthcare needs. Accessing claims details was time-consuming, and data sources were disconnected, requiring manual entry into Excel spreadsheets or SAP Crystal Reports. The IT department had to manually compile the information needed by various departments, making it challenging to see the full picture of individual members.

Solution

In the early stages of Business Intelligence development, Leon Mink, Senior VP and CIO, and Alvaro Reis, VP of IT, evaluated several tools, including Tableau, before choosing the Pyramid Analytics platform. Although CCP is a Microsoft house, IT Director Terry Garzon found the drill-down capability of Pyramid superior to the Microsoft product. Having used Pyramid Analytics in a previous role, she was confident that it would be a good fit for the healthcare plan. She knew that Pyramid would make light work of consuming data from the Clarity databases that integrated with its health information system; that it could do the transformation that would enable data to be surfaced in reports for insights. An OLAP cube was created within an architecture primed for Pyramid functionality and the rapid analysis of data; 15 licenses were bought for users across the finance, claims, and pharmacy divisions. At the time, Pyramid was just launching the latest version of its product and spent two weeks with CCP, fine-tuning the platform’s functionality, aligning it to the health plan’s unique needs. Data was presented to stakeholders at the outset to make the business case clear. “The Pyramid team was excellent throughout,” said Terry Garzon, “and always willing to go the extra mile.”

Impact #1	The Pyramid analytics platform has helped improve the quality of CCP’s service, giving its finance, claims, and pharmaceutical teams the visibility they need to optimize member engagement while meeting regulatory requirements.
Impact #2	A huge service provider database that was sluggish to use can now be accessed more quickly, inputting search criteria like the National Provider Identifier, and correlating with other information using drag-and-drop filters.
Impact #3	The Pyramid platform has freed up CCP's IT team from time-consuming tasks, not just correcting bad data but attending briefings on report requirements and manually compiling data with spreadsheets. They are now able to focus on more business-critical tasks.

Impact #1

The Pyramid analytics platform has helped improve the quality of CCP’s service, giving its finance, claims, and pharmaceutical teams the visibility they need to optimize member engagement while meeting regulatory requirements.

Impact #2

A huge service provider database that was sluggish to use can now be accessed more quickly, inputting search criteria like the National Provider Identifier, and correlating with other information using drag-and-drop filters.

Impact #3

The Pyramid platform has freed up CCP's IT team from time-consuming tasks, not just correcting bad data but attending briefings on report requirements and manually compiling data with spreadsheets. They are now able to focus on more business-critical tasks.

Benefit #1	15 licenses were bought for users across the finance, claims, and pharmacy divisions.
Benefit #2	Around 150 metrics have been created that can be used to calculate a range of costs.

Benefit #1

15 licenses were bought for users across the finance, claims, and pharmacy divisions.

Benefit #2

Around 150 metrics have been created that can be used to calculate a range of costs.

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Overview

Pyramid helps health plan provider put people first

Operational Impact

Quantitative Benefit