Case Study: a leading U.S. health insurance company achieves opioid education cost savings with EXL

Healthcare payer achieves significant cost savings with opioid education program

EXL worked with a leading U.S. health insurance company that wanted to better address the opioid epidemic among its members. The payer needed a way to identify members most likely to benefit from education about opioid use, safety, and dependency risks, and to deliver targeted content at the right time through a patient journey analytics approach.

EXL helped the payer build and run a pilot program using data science and a comprehensive opioid risk profile based on demographics, claims, and social determinants of health. The program used predictive modeling and A/B testing to target at-risk Medicaid members and educate them after their first opioid prescription, leading to about a 20% reduction in cost per member per year for targeted members and 2% savings in total expected medical cost, with the campaign still continuing today.