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Accenture helped a major Swiss health payer to create a new data warehouse, improve data management and establish a business intelligence unit.
The new systems better support decision making and regulatory compliance and have helped reduce claims costs by more than US$10 million per year.
Helsana Versicherungen AG (Helsana) is the leading health payer in Switzerland, providing coverage to nearly 2 million individuals, families and organizations across the country. In 2007, the company reported revenues of US$4.8 billion.
Top health payers depend on data warehousing to excel at claims management and marketing. Those that capture the right data and can perform sophisticated analyses are better able to provide customers with quick service and a diverse set of complex products. These capabilities also enable regulatory compliance.
Helsana’s data warehouse could no longer meet its business needs. The data warehouse struggled to handle the volume and types of data needed by Helsana’s staff. And, it was not adequate for the Swiss government’s new information standards and detailed reporting requirements.
In addition, the aging infrastructure was increasingly unstable and not well suited to support new applications. The data structure was inflexible and did not easily accommodate the creation of new reports. Data quality and data mining capabilities were lacking. Finally, the system offered limited possibilities for decentralized data analysis.
Helsana decided to implement a new data warehouse that could address these limitations and help reduce claims-related costs. The carrier chose to work with Accenture due to our technical skills with systems integration and information management as well as our industry knowledge and proven record of helping health payer companies achieve high performance.
As a first step, we worked with Helsana to define the data requirements and the components of a successful business intelligence capability. We documented the conceptual data model, data warehouse architecture, data migration approach, implementation plan and business case.
Once the objectives were identified, we performed an unbiased evaluation of potential software solutions. Based on Accenture’s findings, Helsana selected a database solution from Teradata, data mining and analytics applications from SPSS Clementine and IBM Cognos business intelligence software.
Next, we designed and developed the data warehouse, built a proof-of-concept technical infrastructure and established a new reporting environment. Accenture Delivery Methods helped make the effort a success, as did our longstanding global alliance relationships with Teradata and IBM Cognos.
The cornerstone of the data warehouse is a two-terabyte database integrated with relevant software; reference data from government and national health department sources; Helsana’s core data source systems; and a number of Helsana’s existing applications.
An important feature of the new data warehouse is a customized interface that provides easy access to department-specific product lists, which had previously been maintained using standalone spreadsheet applications. This feature allows each of Helsana’s departments to create the reports they need more quickly.
As the data warehouse was being rolled out, Helsana decided to establish a dedicated business intelligence unit that would concentrate all of the organization’s reporting, data mining and analytical activities in one place. Helsana asked Accenture to help develop a governance structure for the new unit, as well as new processes, responsibilities and role-based data access rights.
This effort marked the first of many additional projects that Helsana has awarded to Accenture. Today, based on the success of its data warehousing and business intelligence work, Accenture serves as a strategic advisor, program manager and systems integrator on a number of projects, ranging from claims department reorganization to post-merger integration.
With Accenture’s help, Helsana has created a robust data warehouse, a superior data management capability and a dedicated business intelligence unit that fully supports the carrier’s data management requirements.
The new data warehouse uses an enterprise data model that boosts data quality, enables more effective data mining and supports daily data loads from source systems. It also allows Helsana to carry out better, faster and more consistent reporting.
The daily reporting capability is an improvement from the old system's monthly schedule. These new reports give Helsana more accurate insights into its business and detailed information for timely action. The new reporting capabilities have also allowed Helsana to meet the Swiss government’s requirement for detailed reports.
The business intelligence unit applies sophisticated analytical tools to gain insights that would previously have remained hidden. Helsana can identify insurance fraud and abuse more quickly, assess the quality of care providers more accurately and examine claims data in tremendous detail. In addition, because the database stores historical data records, Helsana staff can review information as it was at any point in time.
Better information management helps position Helsana for high performance. Executives can now use the data at their disposal to react to business and market changes more quickly. Sales and marketing teams use the data to improve their lead identification activities and achieve higher closing ratios.
Perhaps most importantly, improved data quality and visibility—along with new analytical tools—have helped Helsana reduce its claims costs by more than US$10 million per year.
The new systems set the stage for long-term success. According to Chief Executive Officer M. Manser: “Helsana now has a strong, future-oriented business intelligence and data warehousing capability that supports our core business processes. Accenture, with its deep technical and business experience, has helped us develop a data infrastructure that is fast, scalable and reliable. That infrastructure, in turn, helps us understand our business and the risks of our insureds more clearly. It contributes to improved operational and financial performance. And it enables us to deliver better products and services to meet the needs of our customers.”
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