Next Best Action

Abdul August 18, 2020

Leading Healthcare Insurance Provider

Problem Statement

• Healthcare insurance provider has enrolled its plans on Health Insurance Exchange
• To identify the right program-channel combinations at a member level that can be deployed to make CBC’s member base healthier and more wellness oriented

Analytics Led Approach

• The Universe population was subjected to various exclusion criteria before being stratified into High, Medium and Low Priority Buckets based on the Severity of the Disease and Rate of Disease Progression
• Respective channels were mapped based on the Priority Buckets and CMDM ‘Propensity to Engage’ bucket was assigned to the members

Business Impact

• The Universe Population is segmented into buckets on basis of major KPI’s
• Members were segregated into three segments – High , Medium and Low Priority Customers according to he Stratification logic
• CMDM Scores for ‘More Likely to Engage’ mapped for added value

Critical Success Factors

• Advanced analytical process to identify Member – Channel Mapping
• Ability to pro-actively segment and target High Priority members through right Channel to ensure increased engagement and minimize costs