lexisnexis healthcare overview
TRANSCRIPT
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LexisNexis Risk Healthcare Solutions Steve Pawlak
Health Care Provider Solutions Specialist
Delivering data and analytics that enable better health care decisions
What Makes Us Unique
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LexisNexis Risk Solutions is a $1.5B business division of a ~$10B company
Reed Elsevier Revenue Snapshot
LexisNexis Legal & Professional
26% 14%
11%
15% 34%
Elsevier
Reed Business Information
Reed Exhibitions
LexisNexis Risk Solutions
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We provide insight to customers across multiple industries
• Decades of experience in managing identity risk in Insurance, Finance and Government
• Solutions combine LexisNexis Data, Customer Data and Scoring/Analytics to reduce Identity Fraud
• Secure, proven contributory solutions and technology
• All 50 U.S. States
• 80% of U.S. Federal Agencies
• 70% of Local Governments
• 100% of U.S. P&C Carriers
• 100% of the top 50 U.S. Banks
• 90% of the Fortune 500
customers
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Our proprietary technologies allow us to aggregate, link, analyze, and manage vast sources of data to deliver answers to critical business questions
The ingredient behind our products that turns disparate information into meaningful insights. This technology enables customers using our products to identify, link and organize information quickly with a high degree of accuracy.
Data-intensive processing and delivery platform developed that incorporates a software architecture implemented on commodity shared-nothing computing clusters to provide high-performance, data-parallel processing and delivery for applications utilizing Big Data.
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LexisNexis solutions leverage data about people, businesses, and assets to assess risk and opportunity associated with industry-specific problems
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Identity Authentication and Risk Assessment
Contributory Data
Public Records
Credit Headers
Phone Listings Insurance
Financial Services
Collections
Legal
Government
Health Care
Assess underwriting risk and verify applicant data; identify and intercept fraud; improve policy administration and client retention
Prevent/investigate money laundering and comply with laws Prevent/investigate identity fraud
Assist collections by locating delinquent debtors Assess collectability of debts and prioritize collection efforts
Locate/vet witnesses, assess assets/associations of parties in legal actions; Perform diligence on prospective clients (KYC)
Locate missing children/suspects; research/document cases; reduce entitlement fraud; accelerate revenue collection
Verify patient identity, eligibility, and ability to pay Validate provider credentials; prevent/investigate fraud
Retail Protect revenue and maximize operational efficiencies Predict and prevent retail fraud
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8.9 Billion unique
name/address combinations
4 Billion
property records
3.7 Billion
motor vehicle registrations
37 Million unique
businesses
417 Million criminal records
269 Million
auto and home claim
records
188.5 Million unique
cell phones
Partial snapshot of US data sets as of 07/25/14
LexisNexis maintains over two petabytes of unique data comprising billions of public and proprietary records, with the capacity to scale up easily and cost effectively
60 million more
unbanked individuals than traditional credit
bureaus
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The LexisNexis Health Care portfolio has grown as a result of acquisitions that have further built our ability to support the needs of the segments we serve
End-to-end fraud, waste and abuse solutions.
Clinical analytics
focused on population
health management and provider performance.
Provider data and analytics
solutions.
Health care data,
information and
technology solutions.
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Our unique coupling of key assets help transform the way health care is coordinated, delivered and administered
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Data Mining
Predictive Science
Linking Analytics Identity Analytics
Identity Analytics
Master Data Management
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Our broad portfolio of health care solutions are underpinned by unique datasets, powerful processing power, and industry-leading analytics
Solutions
driven by
HPCC Technology
LexID®, MEDai Science, AccuSync®, MDM platform, and more…
Leading Analytics
Provider Pharmacy Life Sciences
Public Records
Provider Referential
Data
Medical Claims
Affiliation Data
Pharmacy POS
Unique Data Assets
Payer
Payment Protection
Clinical Solutions
Identity Analytics
Provider Data Management
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We help our customers meet current challenges and demands
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Manage provider relations more effectively
Engage members and improve member health
Manage data complexities
Meet mounting regulatory requirements
Curb wasteful spending
Focus sales and marketing outreach
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Our data and analytics fuel solutions that reduce fraud, manage identities, improve health outcomes, and increase efficiency tied to data management
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Provider Pharmacy Life Sciences Payer
o Fraud, Waste & Abuse
o Population Health Management
o Provider Performance Management
o Identity authentication
o Provider and Member Data Management
o Population Health Management
o Provider Performance Management
o Knowledge-based Authentication
o Patient Data Hygiene
o Provider Data Management
o Expense remediation
o Expense standardization
o Master data management
o Data cleansing
o Record Linkage and merging
o Data access and integration
o Data profiling o Parsing o Standardization o Identity
resolution o Record Linkage
and merging o Data cleansing o Data
enhancement o Geo-coding