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Profitability & Cost Management in the Health Insurance Industry

Oracle Hyperion Profitability and Cost Management supports the core requirements of the Healthcare Insurance industry and provides value for a broad range of use cases. For core profitability management, HPCM helps managers gain visibility and understanding of the cost to service different healthcare plans, group business and members. It helps provide an accurate understanding of profitability by member segment, healthcare plan and distribution channel. Based on this new insight, managers can improve marketing programs through better member segmentation and make more confident operational decisions about plan design and services. In addition, HPCM helps Finance and Operating Staff provide more complete documentation and audit trails for regulatory reporting and to visually justify Medical Loss Ratio results.  (see attached solution sheet)

I’ve worked with several costing solutions, both with and without the requirement to build (and sometimes duplicate) the underlying data warehouse needed to support the application and I’ve been frustrated by the need to implement a point solution for this which essentially duplicates the claims data from the data warehouse for allocations and complex multi-step calculations.  Some of these solutions literally required 40 or more hours to process all the data!   The HPCM solution leverages your data warehouse investment along with the powerful Essbase Analytic engine to manage large amounts of data and calculations.

Perficient, Inc. is uniquely positioned to help your organization implement Oracle Hyperion Profitability and Cost Management solution by leveraging our extensive background with Healthcare EPM and our industry leading Healthcare Management Consulting practice.

Click to access improving-profitability-br-326898.pdf

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Terie McClintock

Terie McClintock is the Oracle Healthcare Practice Director at Perficient, Inc. where she is responsible for providing healthcare subject matter expertise to the Perficient Oracle National Business Unit while also cultivating and managing the partnership with Oracle’s Healthcare Vertical and Horizontal Business Units. Terie has more than 25 years of IT experience. Prior to joining Perficient, Terie contributed over 13 years at M.D. Anderson Cancer Center with the most recent title of Director, Data Management Services. Prior to M.D. Anderson, Terie worked for IBM as a Senior Consultant.

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