Business Intelligence Solutionsfor Healthcare Payers
MOBILE INTELLIGENCEMOBILE INTELLIGENCE
2
Leader in Business Intelligence for Over 20 Years
Business Intelligence (BI)
The process of transforming raw data into meaningful information to enable more effective business insight and decision-making
MicroStrategy, Incorporated (NASDAQ: MSTR)
• Founded in 1989
• Leading independent business intelligence software vendor
• Over 1 million business users at over 3,000 organizations
• Direct operations in 42 cities in 23 countries around the world
• Over 70 patents pending or issued
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Healthcare Payers Success Stories
Providing Insight into Benefit Costs and Business Intelligence Best Practices
Founded in 1938, the Hawaii Medical Service Association (HMSA) is a nonprofit, mutual
benefit society and a member of the Blue Cross and Blue Shield Association. Nationally,
HMSA and 38 other Blue Cross and Blue Shield plans provide worldwide coverage to more
than 98 million members. Standardized on MicroStrategy since 2001, HMSA is expanding its
MicroStrategy deployment to include MicroStrategy Report Services™ and has purchased a
new subscription to MicroStrategy’s Technical Advisory Services, a program that enables its
subscribers to tap into best practices in business intelligence. Against a multi-terabyte IBM
DB2 database, healthcare and financial analysts utilize the MicroStrategy platform to track and
assess business data across clinical and financial areas to provide users with greater insight into
the company’s benefit costs.
Offering Transparency intoMedicare Spending Data on 40 Million Hospital Admissions
The new information dashboard recently launched by the Centers for Medicare & Medicaid
Services (CMS) is powered by MicroStrategy. The new CMS dashboard offers an exciting tool
in support of President Obama’s initiative for transparency and open government. In addition
to providing the American public with detailed insights into Medicare spending, the dashboard
data can be used by government and industry to assess health care policies, improve the
management of health care, and identify areas for change. With data from over 40 million
Medicare hospital admissions, the dashboard enables the public to view the relationships
between cost and volume of Medicare admissions by State, starting in January 2006. Every
month, the data will be updated with nearly one million more admissions.
Flexible Reporting for Cost-Containment Solutions
Formed in 1976 and based in Tampa, Fla., PMSI-Tmesys is one of the nation’s leading
providers of cost-containment solutions for pharmacy and specialty services in the workers’
compensation and catastrophic injury markets. PMSI-Tmesys clients can generate user-
friendly reports on medications prescribed to a particular claimant, top-prescribed drugs, top
dispensing pharmacies, and payer-specific savings, among other criteria. Using MicroStrategy,
the users have the flexibility to drill down into the data, analyze it, export it, customize it, and
present it in a number of different ways. Previously, PMSI-Tmesys clients received monthly
reports via e-mail, with little control over the frequency and appearance of the reports.
Enhanced Visibility Into Financial, Operational, and Clinical Performance
The Advisory Board Company is the leading worldwide health care research and professional
services firm serving more than 2,600 hospitals, health systems, and healthcare insurers. The
Advisory Board provides multiple, hosted business intelligence applications, each focusing on
a distinct area critical to hospital margin and clinical improvement and each leveraging the
Advisory Board’s deep industry expertise. There are currently thousands of individual users –
from CFOs to business analysts – accessing the applications on a daily basis.
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Leverages Data Assets with MicroStrategy BI Deployment
The Challenge Harvard Pilgrim Health Care provides a variety of benefit
options and funding arrangements to more than one
million members throughout Massachusetts, Maine and
New Hampshire. Its mission is to improve the health of
the people they serve and the health of society. Harvard
Pilgrim is the #1 private health plan in America according
to an annual ranking of the nation’s best health plans by
the National Committee for Quality Assurance (NCQA)*.
Harvard Pilgrim is the only private health plan in the nation
to be named #1 for member satisfaction and quality of
care for seven consecutive years.**
Prior to building a comprehensive and robust Enterprise
Data Warehouse, Harvard Pilgrim’s reporting requirements
were met through a claim centric data warehouse and
the use of SAS and SQL data access tools. Finance’s 60
analysts were the only business unit that had access
to the warehouse. Other departments made requests
for information to the Finance Department or relied on
production reports that were scheduled. Analysts were able
to change parameters but lacked ad hoc query capability.
The Process Harvard Pilgrim convened a cross-enterprise committee
to assess BI technology. Membership on that committee
included finance, provider and network relations, customer
service, and care management departments, as well
as representatives from the technical architecture and
EDW staffs. The committee identified evaluation criteria,
including ability to access multiple data sources, richness
of data presentation capabilities, ease of use, and technical
reliability. MicroStrategy (www.microstrategy.com) was
the preferred solution on the part of both business and
technical representatives.
Implementation
The initial implementation was for Employer Analytics
which includes both external and internal access to the
EDW. Employer Analytics has been available for 18 months
and between 2,000 and 2,500 reports are run weekly.
Employers and brokers are using the data to watch their
medical utilization and costs which helps them to budget
their medical expenses (most large employers are self-
insured) and make decisions on what care and wellness
programs might be beneficial to their employees. Harvard
Pilgrim has deployed the MicroStrategy technology to five
internal departments and has two additional business units
awaiting implementation.
Future Focus
Harvard Pilgrim has two future objectives. The first
is to continue meeting the analytic needs of existing
departments as well as expand the capability into other
departments. The second priority is to move the company
closer to identifying key performance indicators which
will be used to populate dashboards and more effectively
use visualization tools. Having a strong and maturing BI
capability within Harvard Pilgrim positions the company to
move rapidly toward more sophisticated tools and analyses.
Within a few months Harvard Pilgrim will deploy a provider
dashboard which will be available to providers as well as to
internal analysts. This deployment will be the first initiative
to use dashboards and will lead the way to future use of
complex analytic methodologies.
Harvard Pilgrim’s investment in BI technology infrastructure,
domain expertise and an ever expanding number of
stakeholders with access to critical information positions
the company for future competitive differentiation.
Executive Summary
Health plans have long struggled to develop and
operationalize a Business Intelligence (BI) strategy.
Burdened with multiple BI applications as well as
healthcare specific analytic applications, health plans
have struggled to create the single source of truth
and extend access to information for managers and
executives. The inability to leverage data across a health
plan has led to decision making that lacks evidence.
Harvard Pilgrim has successfully built an Enterprise
Data Warehouse that includes all available data and
has increased access to that information across the
enterprise through the use of the MicroStrategy BI
technology. Managers and executives are making
better decisions more quickly than in the past which will
only become more important as competition continues
to increase and strategic and tactical decisions become
more significant. * NCQA’s Health Insurance Plan Rankings 2010-11 – Private
** U.S. News/NCQA America’s Best Health Insurance Plans 2005-2009 (annual). America’s Best Health Insurance Plans is a trademark of U.S.News & World Report. NCQA
The State of Health Care Quality 2004.
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MicroStrategy Enables Insight & Action Across the Payer Enterprise
MicroStrategy Healthcare Solution Map
Health Plan Solutions
Cost of Care
HEDIS
Member Management
Care Management
Provider Data
Personal Health Record
Fraud & Abuse
CRM
Enrollment
Gaps in Care
E-Claims
Commissions Management
Contract Management
Appeals and Grievance
Medical Budget
Network Management
Markerting & Sales
Performance Measurement
Rating & Underwriting
Health & Wellness
Reimbursement Modeling
Member Engagement
Portals
E-Billing
Medicare Reconciliation
Disease Management
Benefits Modeling
Purchaser Management
Claims Analysis
Member Satisfaction
Health Risk Assessment
Patient Centered Medical Home
Member Solutions Hospital and Physician Physician Employer Solutions
Benefit DesignGaps in CareE-Billing Eligibility E-Billing & Payment
Enrollment
Disease MangagementAuthorization Performance Analysis
Employer Analysis
Claim Status
Enrollment Reconciliation
HEDIS
Enrollment E-Billing
Claim Status Benefit Selection
Personal Health Record Gaps in Care
Disease Management Prevention Screening Disease Management
Health & Weallness
Corporate Solutions
GAPP Financial Reporting
Regulatory / Compliance
Enterprise Risk Management
Real Estate PlanningCorporate
PerformanceHR / IT
PR / Investor Relations
Accounting
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Solutions for Healthcare Payers – Cost of Care Analysis
Actionable Insights to Manage Medical Costs
Health plans must always monitor their key medical
expense trends. MicroStrategy, with Talon Analytics,
can rapidly enable mobile and web analytics. This
enables your health plan to monitor expenses at the
member, group, and disease grouping level, and
take action.
Mobile access to these key indicators allows executives
to always be in step with utilization and expense
variations. From their mobile device, users can easily
drill into clinical categories (groupers) to identify the
providers and members claim level detail. Plans can
also embed predictive risk scores, at the member level,
to enable clinical interventions and support member
engagement.
Cost of Care AnalysisiPad 1:55 PM 100%
MOBILE INTELLIGENCE alonTM
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Solutions for Healthcare Payers – Claims Performance Management
Mobile Access to Manage Your Cost Ratios During the ICD10 Transaction
Claims management is critical to managing a health
plan’s administrative expense. Quick and efficient claims
processing increases provider and member satisfaction,
optimizes settlements, and minimizes expenses. Analyzing
and proactively managing the end-to-end process across
regions, claim systems, product lines, and business units
helps insurance companies better understand their most
critical components in operational effectiveness and
member retention.
Claims Performance Management
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Solutions for Healthcare Payers – Care Management
Comprehensive Access to Member Data
Care management programs are created to appropriately
manage health resources and improve member wellness.
Successful Care Management programs depend on a health
plans ability to connect data sources across organizational
boundaries. MicroStrategy enables the health plan to bring
together these data sets – medical and pharmacy claims,
membership and eligibility data, contracts, case management
and health risk assessment. This allows a plan to monitor
chronic disease programs as well as achieve a 360˚ view of
their members.
Care Management & Member 360
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Solutions for Healthcare Payers – Patient Centered Medical Home
Mobile Access to Quality Measures for your providers and your network teams.
The PCMH model stands to be a crucial part of
healthcare reform – one that rewards quality, not
quantity, of care. Successful PCMHs have the ability
to monitor and report on key quality measures
around access to and effectiveness of care, physician
engagement and appropriate use of services.
MicroStrategy enables the PCMH team to efficiently
and effectively manage their patient population by
providing access to accurate and updated patient data
across care settings and over time. This allows providers
to take actions that result in decreased duplication of
services, lowered hospitalization rates, and improved
quality of care and patient outcomes.
Patient Centered Medical Home
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Why Do Tier One Healthcare Payers Turn to MicroStrategy?
Comprehensive ActionableAccessible
Only MicroStrategy Provides Healthcare Payers with Solutions that are Comprehensive, Accessible, and Actionable.
on the fastest, most robust BI platform...
Industrial StrengthHigh Performance Delivered Even at
the Highest Scale
Non-stop Operations
In-memory Performance
Highest Scalability
Complete Security
to complete any type of analysis.
All Styles of BIEvolving Requirements Fully Supported Out-of-the-Box
Predictive Analytics
Dashboards
Reporting
Alerts & Monitoring
Analysis
when and where you need it...
All InterfacesInformation Delivered Where
and When Users Need It
Mobile
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$ 6,798.11$ 1,699.53
April 15, 2010
Summary as of April 1, 2010
PayBill
7 charges in this periodLarge Charges
Spend by expense category
Rewards Information
Special offers just for you
iPad 1:55 PM 100%
Channel Overview
Web
Catalog
<15k0
20,000,000,000
450,000,000
400,000,000
350,000,000
300,000,000
250,000,000
200,000,000
150,000,000
100,000,000
50,000,000
0
40,000,000,000
60,000,000,000
80,000,000,000
100,000,000,000
15k-25k 25k-50k 50k+
50+
Total Visits
Top Buyers
Request Visits
Under-drivenPurchases
Offer-drivenPurchases
16-25
25-35
35-50
Off-Price Stores
Traditional Full
Price Stores
Trend and per-Channel Ranking Current, Last, Last Year’s Quarter
City
Location Income
<15k
15k-25k
25k-50k
50k+
<15k
15k-25k
25k-50k
50k+
3.92%
3.92%
3.93%
3.79%
3.00%
3.09%
3.00%
2.99%
54.34%
54.32%
54.25%
47.79%
39.69%
39.67%
39.67%
36.45%
Current Conversion % Other Conversion % Other Trend
Rural
Series: Repeat VisitsCategory: 20092Value: 348,604,353
Series: WebCategory: RevenueValue: 186,810M
Desktop
January 6, 2006
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Web
Printers
6/15/2009
Turn large amounts of complex data into a single
version of the truth...
All Data SourcesAccessing All Enterprise Data
DataMarts
Data Warehouses
Salesforce.com
Spreadsheets, Text Files
Oracle Essbase
Microsoft Analysis Services
Mu
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Datab
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The Platform for Healthcare Business Intelligence
MicroStrategy’s Extensive Platform Experience Conveys Directly to Mobile BIThe MicroStrategy platform is built on one unified, organically-
developed architecture. This platform provides a number of critical
capabilities to ensure that it is truly enterprise-class:
Rapid Development and Deployment using WYSIWYG point-
and-click design in the MicroStrategy integrated development
environment.
High Scale and High Performance across user scale, data scale,
and application scale on the fastest, highest performing business
intelligence server.
Economies of Scale as the system grows with the minimum
number of IT personnel and the fewest servers.
‘Write once, run anywhere’ Flexibility from a single service-
orientated architecture to satisfy multiple devices and clients
without additional integration or device-specific translation.
Openness and Extensibility via MicroStrategy’s SDK and
extensive library of APIs.
Secure Data Access Model designed to provide robust data
protection using a full range of technologies and security models.
Comprehensive Administrative Control consistent with
mission-critical system operation.
Unmatched Analytical Power against entire data warehouses
using data mining, predictive, statistical, financial, and
mathematical analyses.
MicroStrategy Mobile Business IntelligenceFASTER TO DEVELOP – Quickly design apps that offer a superior user experience, knowing that infrastructure code such as
networking, security, data management, and sensor integration is already built-in.
NO CODE REQUIRED – Customize the look, feel, and behavior of your app using an array of finely-designed, iPhone-optimized
displays and controls. MicroStrategy’s intuitive point-and-click interface makes configuration easy.
EASIER TO MAINTAIN – Accelerate deployment of new apps and stream app updates with the MicroStrategy Mobile application
platform, so users always have easy access to the latest, most up-to-date information.
Browser
Desktop / Laptop Mobile
Full Spectrum ofDeveloper Tools
Full Spectrum ofAdmin Tools
MicroStrategy
Web
MicroStrategy
Intelligence Server
MicroStrategy Transaction Services
MicroStrategy
MobileWeb
Professional
DesktopDesigner
EnterpriseManager
CommandManager
ObjectManager
IntegrityManager
Architect
Databases TransactionalApplications
WebsiteContent
CubeDatabases
SDK
Office
xx
x
Portals
x
Windows iPad
iPad 1:55 PM 100%
BlackBerryiPhone
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Business Intelligence Transactions Content Delivery
Grids Graphs Data Explorations
Data Visualization
Analytics Mapping Alerting Approval Mgmt.
Editable Grids
Data Entry Browser Content
Payments Desktop Publishing
PDF’s ePubs Video
• Analytics, Grids, & Graphs• Data Visualizations & Exploration
• Mobile front-end to ERP/CRM• Sell products and schedule services
• Mobile Information Channels• MultiMedia Libraries and Delivery
Mobile Apps Combine Three Core Capabilties
iPad 1:55 PM 100% iPad 1:55 PM 100%iPad 1:55 PM 100%
3M 6M 12M
Table Win GAMING
350K
300K
250K
200K
150K
100K
50K
Dec Jan Feb
2/13/2011 Yesterday
EBITDA
GAMING
PLAYERS
HOTEL
EXPENSES
YSTR LYEBITDA $299,663 (7.6%)Revenue $427,896 (2.1%)Expenses $128,233 13.9%
YSTR LY
Revenue $374,285 1.4%Table Win $182,307 (17.1%)Table Drop $902,677 39.6%Table Hold % 20% (13.8%)Slot Win $191,978 28.5%Slot Coin In $3,359,213 37.7%Slot Hold % 6% (0.4%)
YSTR LY
Rated Players 666 35.6%Gaming Theo $308,066 29.5%
YSTR LYRevenue $53,610 (20.9%)ADR $242 0.3%RevPAR $208 5.6%Booking 82 0.0%
YSTR LYPromotions $2,614 4.2%Events $1,845 4.2%Others $123,774 14.3%
Sections i
Casino AnalysisClose
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Visualize Patterns and Trends in Your DataSnap Barcodes to Use as Inputs for Your Analysis
Camera An Extensive Library of Graphs
Bubble Chart BoxPlot
Bar and Line Chart
Area and Line Chart
Waterfall Chart
3D Bar Graph
Histogram
Gantt Chart
Radar Chart
Line Chart
Track medications and medical supplies
Scan patients’ identification and insurance information
Mobile Apps Combine Three Core Capabilties
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Easily Explore, Save, and Share Analyses
With Visual Insight, Everyone can Become an Information Publisher
1 2 3Explore Data Visually Save Visual Analyses Share with Colleagues
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Keeping Your Business at Hand, Anytime, Anywhere
Providing answers 100x faster than traditional BI by reducing the need for
IT support is a powerful business capability. Changing the Way People get
answers by allowing all users to upload and analyze business data takes that
power to a new level.
Get the Business Answers You Want Immediately.
1. Extremely Fast To Generate Business Answers
2. Highly Visual Data Presentation
3. Powerful and Simple Exploration
4. All Business Data (Enterprise, Department, or Personal)
5. Save and Share Insights
6. Available on Web and Mobile Devices
Visual Insight Data to Insight in Minutes
Upload Business Data
Discover Insights
Data-to-Insight Total
Traditional BIData to Insight in Months
Define Requirements
Engineering the Data
Architect the Data
Design Initial Reports
Refine Report Designs
Discover Insights
Data-to-Insight Total
30 Days
30 Minutes
7 Days
10 Days
2 Days
5 Days
5 Days
1 Days
30 Days
5 Mins
25 Mins
30 Mins
30 DAYS
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Monitoring your organization’s performance in the palm of your hand is a
powerful business capability. Interacting with that information to approve requests,
submit orders, change plans, and capture information at the moment of insight
takes that power to a new level
Don’t Just Analyze Data, Take Action.
MicroStrategy Transaction Services lets plan employees and members act on
business information from a mobile device such as the iPad and iPhone, as well as
from a dashboard on any web browser.
For example, Transaction Services enables the provider to dispute any patient
level quality measures (e.g. if the plan does not have record of a lab test, or
recommended preventative screening, the physician can note this using transaction
services on his or her mobile device).
By allowing the physician to respond to the payer when providing care,
disagreements can be settled quicker and care can be better monitored. This
allows for the necessary adjustments to be made by both parties.
MicroStrategy Transaction Services™
iPad 1:55 PM 100%
Empower Your Users to Take Action on The Move
Document physician and member clinical notes in the field requiring your action
Approve requests based on information presented
Deny requests at the tap of a button
Reassess ongoing requests by asking the requestor for more information
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Mobile Transactions Will Enhance All Existing Transaction Systems
Mobile Transactional Apps Enhance and Extend Existing Transaction Systems
MicroStrategy Transaction Services™
Feature Benefits
Always AvailableApprove purchase orders while you wait for the elevator.
Secure
Authenticate who you are, wipe access if lost or stolen.
Context AwareIncorporate GPS, bar code, location awareness, NFC.
Auditable360 activity record, provides an audit trail.
Mobile Always AvailableSecureContent AwareAuditable
Web Tethered Limit Use
ERP / CRM Operational
Systems
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Partners in Healthcare Payers Solutions
Strong Partnerships with Over 200 World-Class Providers
System Integrators
Applications
Database / Technology
TMalon
Found from websiteModify PMS
PMS 200 RedPMS 424 Gray
The Data Virtualization Gold Standard
The business intelligence experts.
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What MicroStrategy Healthcare Customers are Saying: The Buzz
Better, More Insightful Research In the Fight Against Cancer
We selected MicroStrategy because of its exceptional scalability, core reporting, and analytic functionality. MicroStrategy positions is to provide better quality and more timely information to our clients, giving them critical insights to make analytically based decisions.
- PMSI–Tmesys
Helping Payers Reach Top Tier Performance
Our research shows that top performing organizations separate themselves from their peers by their ability to quickly diagnose the root cause of recurring problems and issues and spend time not on diagnosis but on driving to solutions. Our business intelligence membership programs -- which include our distinctive business intelligence tools on MicroStrategy’s platform as well as our best practice research and domain expertise to drive ongoing improvement -- really help our member hospitals reach and maintain the top tier of performance.
- The Advisory Board
Creating Applications for Quick Decision Making
Our experience selecting MicroStrategy and working with them to build the app has been fantastic.
- Novation
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Copyright Information
All Contents Copyright © 2011 MicroStrategy Incorporated. All Rights Reserved.
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Patent Information
This product is patented. One or more of the following patents may apply to the product sold herein: U.S. Patent Nos. 6,154,766, 6,173,310, 6,260,050, 6,263,051, 6,269,393, 6,279,033, 6,567,796, 6,587,547, 6,606,596, 6,658,093, 6,658,432, 6,662,195, 6,671,715, 6,691,100, 6,694,316, 6,697,808, 6,704,723, 6,741,980, 6,765,997,
6,768,788, 6,772,137, 6,788,768, 6,798,867, 6,801,910, 6,820,073, 6,829,334, 6,836,537, 6,850,603, 6,859,798, 6,873,693, 6,885,734, 6,940,953, 6,964,012, 6,977,992, 6,996,568, 6,996,569, 7,003,512, 7,010,518, 7,016,480, 7,020,251, 7,039,165, 7,082,422, 7,113,993, 7,127,403, 7,174,349, 7,181,417, 7,194,457, 7,197,461, 7,228,303, 7,260,577,
7,266,181, 7,272,212, 7,302,639, 7,324,942, 7,330,847, 7,340,040, 7,356,758, 7,356,840, 7,415,438, 7,428,302, 7,430,562, 7,440,898, 7,486,780, 7,509,671, 7,516,181, 7,559,048, 7,574,376, 7,617,201, 7,725,811, 7,801,967, 7,836,178, 7,861,161, 7,861,253, 7,881,443, 7,925,616 and 7,945,584. Other patent applications are pending.
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