Case Study: a large regional health plan improves member outcomes with EXL Health population analytics

a large regional health plan identifies 2.6% of members at future risk with EXL

A large regional health plan was facing the common challenge of successfully engaging members in its care management programs. Despite being able to identify at-risk members, their efforts to improve engagement and compliance with care plans were falling short, all without overburdening nursing staff. To address this, they partnered with vendor EXL and utilized its population health analytics solution.

EXL implemented a unique three-pronged approach for the health plan. This involved moving from reactive to proactive care by identifying members likely to become high-risk, assessing which populations were both impactable and intervenable, and implementing intelligent engagement strategies based on clinical gaps and preferred communication channels. As a result, EXL helped the health plan identify a specific population cohort that offered 17 times the savings opportunity compared to other groups. This empowered members to better manage their health, leading to avoided emergency visits and inpatient stays, improved quality of life, and reduced overall costs.