accenture cloud-based lab reviews case study
TRANSCRIPT
Avalon: Providing cloud-based lab reviews at lightning speed
Overview
Accenture built a first-of-its-kind platform on the public cloud for Avalon Healthcare Solutions, helping payers reduce unnecessary lab spend while maintaining quality care.
Copyright © 2016 Accenture All rights reserved.
Client profile
Copyright © 2016 Accenture All rights reserved.
Avalon Healthcare Solutions • Laboratory benefit management
Company founded in 2013
• Headquartered in Tampa, Florida
• Helps health payers manage the cost and effective use of diagnostic lab tests
• Assesses lab charges within end-to-end claims review process
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Project objectives
Avalon sought to accelerate service delivery using a cloud solution Chose Accenture for:
Copyright © 2016 Accenture All rights reserved.
Deep knowledge of the healthcare
industry
Technology skills Cloud-based solutions
Partnership with Amazon Web
Services (AWS) through Accenture
AWS Business Group (AABG)
Copyright © 2016 Accenture All rights reserved. 1. The Health Insurance Portability and Accountability Act (HIPAA) took effect in 2003.
AWS cloud has history of secure operations, essential for complying with health privacy guidelines.1
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Opportunity
Copyright © 2016 Accenture All rights reserved. 2. G2 Intelligence 2010; Francisco Partners analysis.
In the U.S.,
8+ billion lab tests performed annually
30+ percent overused or unnecessary2
Initially, Accenture helped Avalon weigh go-to-market options Avalon chose cloud-based platform vs. high cost of building infrastructure in-house
Solution
Copyright © 2016 Accenture All rights reserved.
AABG supported in the architecture and
build of a 100-percent cloud-based Claims Editor as a Service (CEaaS)
Accenture clinicians assisted in the
development of 130+ laboratory policies
Business rules/algorithms were developed for real-time claim
processing
New portals were built for Avalon’s
customers to access data, claims and
prior authorization
Copyright © 2016 Accenture All rights reserved. 2. G2 Intelligence 2010; Francisco Partners analysis.
AWS’s elasticity supports rapid onboarding of health plans and claims volume
Results
Copyright © 2016 Accenture All rights reserved.
Claims Editor as a Service (CEaaS) cloud-based solution hosted on AWS
Edits up to 150,000 claims per hour
99 percent uptime and 99.5 percent accuracy
Response time per claim averages less than a
second: 856 milliseconds
Copyright © 2016 Accenture All rights reserved.
Flexible: scales as demand grows for Avalon’s services Future proof: Easy to update based on changing insurer policies, research findings, regulations
Analytics capabilities
Copyright © 2016 Accenture All rights reserved.
Claims Editor as a Service (CEaaS)
has built-in advanced analytics
Avalon can mine data for statistical analysis based on
findings from clinical research
Important as new lab tests and treatments
emerge
Analytic Insights help Avalon’s customers save by minimizing
unnecessary lab tests
Copyright © 2016 Accenture All rights reserved.
Thank you! Related content: Accenture AWS Business Group Accenture Healthcare Accenture Operations