A Fortune 500 healthcare payer finds $58M in member growth and retention.
With both competition and cost pressure increasing in their Medicaid business, a Fortune 500 healthcare payer used Unsupervised's Automated Data Platform and AI Agents to look for deeper insights that would improve member growth and retention.
January 3, 2024
The numbers
Opportunities found, first six months
Data sets merged and analyzed
Medicare and Medicaid beneficiaries
More data, more edge
Analyzing the data with Unsupervised made it possible to work through far more of it than they ever had manually. Handling large and complex data sets used to be both a management nightmare and prohibitively expensive. AI made it possible to merge and analyze 26 different data sets across four types: member data, usage data, interaction data, and value metrics. Those sets included both first-party and third-party information.
Unsupervised's AI Agents sifted through enormous amounts of data and extracted specific, actionable insights. They could identify interactions between plans and member types, target markets, and pinpoint aspects of the member experience that influenced Customer Satisfaction (CSAT) scores, profit, and retention. They also determined which indicators correlated with a prospect's likelihood to enroll.
$58M in opportunities found in the first six months.
Insights to action
As the payer connected additional data sets, Unsupervised surfaced ever more granular insights: which customer touchpoints could be optimized for specific groups of prospects, which Medicaid prospects were likely to enroll and engage with plan offerings, and which activities or events correlated with CAHPS scores, profit, and retention.
Dozens of previously unknown insights were identified and used to improve both the patient experience and KPI performance:
- AI-generated, hyper-targeted member segments.
- Targeting specific groups of members for opt-in to the touchpoint channels most likely to be effective for them.
- Highlighting a partner who was particularly effective at working with an underserved patient group.
- Identifying patterns behind underperformance in two counties that could be addressed with improved experience around one diagnosis or one plan.
- Updating online user experiences based on patient insights.
Impact at scale
That work led to both significant business impact and an improvement to the patient experience for over 60 million US Medicare and Medicaid beneficiaries.