Case Study: a leading national health plan achieves clinical efficiencies and quality outcomes with EXL

Leading national health plan achieves clinical efficiencies & quality outcomes through strategic partnership

EXL partnered with a leading national health plan, a Top 5 national health plan and Fortune 500 company, to reduce costs, access global clinical talent, improve analytics, and support growth in clinical operations while adapting to changing business needs. The client needed a proven transformation partner to help manage utilization, disease, case management, and quality processes more efficiently.

EXL implemented a broad clinical operations support model including utilization management, disease management, case management, HEDIS gap closure outreach, and automation/analytics through its DigiCA solution and Healthcare Academy-trained talent. The partnership delivered measurable gains such as an 18% reduction in call handle time, 40% lower case handling time, 39% improvement in gap closure rate, 25-30% shorter cycle time, and 30-35% reduced cost to serve, helping EXL drive better clinical outcomes and operating efficiency.