US Health Plan: Forecasting and Analytics

Accenture helped this large US Blue Cross/Blue Shield health plan develop a powerful forecasting and analytics solution that improves decision making and ultimately drives high performance.

This health plan—one of the country’s largest—offers a variety of indemnity and managed-care health insurance products, along with consumer-driven health plans and Medicare supplementary products.

Changes in the dynamics of the US health industry and increased competition made it imperative for the client to develop the capability to analyze its client base to optimize its decision-making processes. None of the client’s current tools and processes supported client-based forecasts and analysis, while limited data outputs further limited its options. Aside from being scarce, its data was also unreliable.

Leveraging its alliance with SAS, a leading vendor of analytics software, and its existing enterprise performance management methods and leading practices, Accenture developed and helped implement a customized solution for reporting and analyzing client data and profitability. The Accenture Finance & Enterprise Performance team leveraged the experience of Management Consulting and Technology Consulting colleagues to define requirements and develop both the pilot and final solution.

Accenture also helped facilitate access to the analytics skills cost-effectively by involving its specialist SAS teams based in India.

Using driver-based forecasting and scenario analysis, the solution helps the client make informed business decisions about current and prospective customers. The integration of operational and financial data also helps enable more accurate forecasts—and has led to better integration of business processes as well.

Greater data transparency and analytical capability should provide the client with the ability not only to surmount current challenges, but also to develop and test new business ideas that could be a future source of profitability.

The solution’s efficacy goes beyond financial forecasting and reporting: it is also a resource for the marketing, actuarial and sales departments by providing profitability trends for products, clients and divisions.