Since the IBM PureSystems family of expert integrated systems debuted in 2012, IBM has shipped more than 10,000 systems. To mark that milestone, we are presenting a series of stories about clients whose operations were transformed by IBM PureSystems.
Health organizations and insurers worldwide are striving to lower health care costs, and one key tactic is keeping people healthy. However, it requires analyzing scads of data to gain accurate insights into what factors affect health and what actions truly help make people healthier.
In South Africa, Discovery Health manages 14 medical insurance plans covering more than 2.6 million individuals. As the country’s largest healthcare insurance provider, Discovery is known for offering affordable policies.
To maintain its cost advantage over competitors, Discovery needs to constantly refine the clinical risk management capabilities that underlay its policies. That means tapping new sources of data and applying innovative models to pinpoint where health risks are and how best to manage them proactively.
The company, which has 5,000 employees, also strives to minimize expenses resulting from billing errors and fraud.
To gain the predictive analytics capability it needs, Discovery Health worked with IBM Business Partner BITanium Consulting (Pty) Ltd to deploy an IBM PureData System for Analytics solution. The solution included IBM SPSS Modeler, IBM SPSS Statistics and IBM SPSS Text Analytics for Surveys applications.
Discovery’s new predictive risk management solution extracts deeper and more accurate insights from clinical, demographic, billing and even unstructured member data to point out chronic health risk patterns within its member base.
Using the PureData System for Analytics solution, Discovery Health:
- Reduced the time required to run predictive analytics models by more than 99 percent, from nearly a day to minutes
- Identified and recovered more than US$25 million resulting from fraudulent claims and billing errors
- Better targeted preventive programs to at-risk subscribers, thus reducing the overall cost of care and the cost of premiums
The PureData System for Analytics solution gave planners the granular, analytical guidance they need to develop more effective preventive programs. Read more about how Discovery Health is using IBM PureData System for Analytics in the case study.