Leveraging Data Analytics to Improve Healthcare Outcomes at Florida Blue

Consulting Solutions partnered with Florida Blue, a leading healthcare provider, to build a robust big data solution supporting key operational and financial goals. The initiative aimed to drive down medical costs while optimizing healthcare quality delivered by network providers and providing insights into the patient health journey.

• Florida Blue faced the challenge of controlling rising medical costs while optimizing healthcare quality and gaining visibility into the patient health journey.
• Key obstacles included a diverse provider network, complex treatment interdependencies, and lack of a holistic view of patient care, quality, and outcomes.

Consulting Solutions deployed an advanced analytics solution and performance scorecard initiative in three strategic phases:

• Data Discovery: Understood and translated data from disparate systems across Florida Blue’s provider network.
• Data Grouping and Aggregation: Tracked provider services, grouped treatments, and mapped the patient journey using proprietary “Groupers” based on ICD codes.
• Roll Out and Adoption: Developed and rolled out Provider Performance Scorecards to assess costs and quality of services.