accenture cloud-based lab reviews case study

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


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:


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


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


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


Flexible: scales as demand grows for Avalon’s services Future proof: Easy to update based on changing insurer policies, research findings, regulations

Analytics capabilities


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


Thank you! Related content: Accenture AWS Business Group Accenture Healthcare Accenture Operations