Case Study: a large U.S. regional health plan improves reporting, member engagement, and star ratings with EXL CareRadius

a large, U.S. regional health plan boosts star rating from 3 to 4.5 with EXL

A large U.S. regional health plan faced challenges due to its disconnected collection of care management software applications, which lacked integration and made reporting and providing a 360-degree member view extremely difficult. The health plan partnered with vendor EXL to implement its CareRadius™ platform, seeking to automate workflows and enhance collaboration.

EXL's web-based CareRadius™ solution provided an open architecture for self-configuration and integrated disparate data sources. The results included a member engagement rate increase from 30% to 70%, a reduction in report generation time from one year to one day, consistent regulatory compliance, and an improved CMS star rating from 3 to 4.5. EXL's solution also led to a 15% reduction in behavioral health re-admissions and a 20% reduction in medical re-admissions.