Case Study: Large Self Insured Pharma Organization achieves up to 15% savings with EXL Health analytics

Large Pharma Chases Elusive Triple Aim with Implementation of Value-Based Insurance Design

EXL worked with a large self-insured pharma organization that wanted to improve member health outcomes and care experience while also reducing healthcare costs. To tackle this Triple Aim challenge, the company explored Value-Based Insurance Design (V-BID) and needed better analytics to make informed plan coverage and benefits decisions.

EXL Health implemented advanced patient analytics using the EXLVANTAGE data and analytics foundation, providing longitudinal analysis of medical and pharmacy claims data against benchmark information. EXL helped the organization identify high- and low-value services, target members at risk for specific conditions, and assess utilization patterns, leading to an estimated 15% savings opportunity in specific condition categories and better support for V-BID plan design.