Case Studies

Centers for Medicare and Medicaid Services

Contract Vehicle: CMSHelping CMS Make Data-Driven Decisions

Qlarion transforms public health and social service agencies into data-driven organizations by injecting analytics into their business. Our solutions are designed to improve quality of care, ensure access to care, and reduce healthcare costs while streamlining service delivery and improving resource allocation.

Qlarion has been supporting analytics and business intelligence solutions at Center for Medicare Services (CMS) since 2013.

CMS provides coverage for 63 million beneficiaries and processes $350 billion in claims each year. As a result, CMS possesses some of the richest sources of health-related data in the world.  Since 2006, Qlarion has worked across multiple data and analytics projects at CMS to help them leverage this rich healthcare data and find new ways to lower costs while meeting ever-increasing targets for improved outcomes and greater access to care for the beneficiaries they serve.

Beneficiary Contact Center’s (BCC)

 

BCC’s existing BI setup and business objectives were not aligned. Important operational metrics, such as total call volume and speed of call answer, couldn’t be tracked, resulting in slow decision making and uninformed resource allocation.

We redesigned the data integration process, streamlined data sources, eliminated redundancies, and implemented predictive analytics to forecast future cost structure and beneficiary needs.

CMS now has current insight into operational performance of the BCC, and the solution truly reflects their needs. New reports enabled analysis on user experience, and beneficiary satisfaction and eliminated a full day from data processing cycle.

Office of Information Services (OIS)

 

Due to the volume and complexity of their data, OIS needed a centralized team of specialists to manage and operate their expanding BI applications and data integration (ETL) processes

Qlarion managed centralized reporting teams across all major CMS BI technologies (MicroStrategy, SAS, Cognos, Business Objects), developed publicly available CMS dashboards, and consolidated data to respond to ad hoc reporting requests from the White House, Congress and other Federal agencies.

Our work resulted in decreased costs for operations and support, even as the number of BI users within CMS continues to increase. CMS can now respond much more quickly to critical requests for information.

Center for Medicare Management

 

CMM lacked the ability to monitor the use of outpatient therapy to ensure it is only used when medically appropriate.

Qlarion conducted an extensive analysis of the entire therapy claims data set to identify trends and patterns. Relying on data within the IDR data warehouse, we used advanced reporting techniques to develop quarterly reports on the latest therapy data. We also leveraged external data sources that provided relevant therapy-related insights and integrated those sources when appropriate.

CMM’s policy-focused program is now able to rely on an accurate data analysis to drive policy change around the use of outpatient therapy.