At-A-Glance unitedHealth Group | ingenix Public Sector Solutions the total cost of poor Mission quality health care Successfully transforming data to improve We deploy more than 160 products and a dozen solution sets to serve some is $1,700–2,000 per efficiency and quality for government 1,500 UnitedHealth Group payer competitors, 200,000 physicians, 3,500 beneficiary per year.** health care. hospitals, 180 biopharmaceutical companies, hundreds of employers, and insurers in life, workers’ compensation, and property & casualty. We now overview work with more than 50 federal, state, and municipal authorities. There is As the data warehousing and analytic technology arm of UnitedHealth an Ingenix product at work in nearly every U.S. health care organization. Group, Ingenix has a long and proven track record of delivering commercial health care information solutions. UnitedHealth Group, This breadth of experience affords Ingenix a singular perspective on the the 37th largest U.S. corporation*, began developing, acquiring, and U.S. health care market and an unparalleled ability to address the unique integrating the nation’s best-in-class health care information companies requirements of the public sector. to found Ingenix in 1996 as a wholly owned subsidiary. Commitment Clients benefit from our parent company’s stability, financial strength, and Rising costs, policy changes, outcomes measurement, consumer its role as a real-life development partner for many Ingenix applications. involvement—these are not new issues to Ingenix. When they were first UnitedHealth Group invests more than $700 million annually in new expressed by the commercial marketplace, Ingenix responded with robust technology to improve the quality and affordability of health care. data and analytic solutions. Ingenix now responds with equal vigor to public sector health care needs. Today, Ingenix health care informatics—tools and services that transform data into actionable, fact-based decision support—are at work improving efficiency and quality in Medicare, Medicaid, payer, and employer health HEAltH CARE inFoRMAtiCS FoR GoVERnMEnt care programs while enhancing the well-being of their beneficiaries. SolutionS PRoGRAM intEGRitY PRoGRAM MAnAGEMEnt CARE MAnAGEMEnt FRAUD & ABUSE DATA WAREHOUSING RISK ANALYSIS PREVENTION/RECOVERY We are expert in health care data quality, analytic Prospectively assess probable diagnoses, risks of Identify aberrant billing patterns before the claim definition, and value-driven data marts for any hospitalization, and real-time pharmacy claims is paid and investigate/pursue fraud to recovery. size program from a few thousand to millions of to derive individual risk scores at the time of Ingenix commercial clients avoided or recovered more covered lives. We deliver customizable, flexible, and enrollment for up-front care outreach and disease than $180 million in fraudulent claims in 2004. robust data marts to help assess trends and analyze management. By improving the accuracy of patient cost and quality drivers. risk assessment, Ingenix helped one commercial client PAYMENT ACCURACY & EFFICIENCY save an average of $6,502 per high-risk patient while Comprehensive, transparent, rules-based systems ACTIONABLE ANALYTIC APPLICATIONS increasing quality of care. for electronic claims editing and analysis. Dozens of proven management tools for state and UnitedHealth Group subsidiaries have proper claims federal health benefit programs. In-depth analyses PREDICTIVE MODELING payment rates 9–30% better than the industry and trend forecasts (executive and detailed views) High-quality care begins with early identification average, with 95% paid in 10 days. to inform and enhance policy, network, and clinical of beneficiaries who most need help. Ingenix decision making. best-practice tools group episodes of care, FACILITY AUDIT & RECOVERY measure population-based health status, predict More than 370 years’ combined experience BENCHMARKING TOOLS risk, identify care options, and evaluate quality auditing hospital facilities for overpayment Customizable norms, protocols, and best-practice and cost. The science of predictive modeling is recovery. An AmeriChoice Medicaid post-payment tools for more actionable, accountable, and expanding—Symmetry Episode Treatment Grouper study of $463 million in paid claims in five states affordable decision making. The largest health tools are already at work in AR, AZ, CA, ID, MA, found $125 million billed in error and produced $32 care data source available (75 unique sources) covers MN, NC, NY, OK, PA, TN, and VT. million in savings—prospective edit savings could be 600,000 providers, 50 million lives, and 5 billion many times greater. claims records now used by leading health plans PHARMACEUTICAL SERVICES including UHC, Ovations, AmeriChoice, and 18 states. Real-world, post-launch drug safety and clinical PROSPECTIVE PAYMENT effectiveness tracking. Since 1997, we helped one Apply PPS methodology to government beneficiary CONSULTING & INSIGHT commercial client trend 2–6% below national health programs and realize appropriate, accurate, and Expertise to design new benefit programs and to plan average drug costs—saving up to $120 million consistent payments. Ingenix has implemented over forecast costs, utilization, and the impact of new per year. 100 PPS since 2001 and was key in the development medical processes and technologies. Reden & Anders, of modern coding and reimbursement models, starting an Ingenix company, is the second largest actuarial and GSA SCHEDulE 70 - GS-35F-0423J with the inception of Medicare’s PPS at Yale in 1982. health care consulting organization in the country. For information: 703.707.5719 | firstname.lastname@example.org unitedHealth Group ingenix Public Sector Solutions, inc. 1925 isaac newton Sq., Ste. 300 | Reston, VA 20190 | www.ingenix.com *Fortune magazine (April 5, 2006) ranked unitedHealth Group no. 37 in the 2006 rankings of the 500 largest u.S. corporations based on 2005 revenues. **Midwest Business Group on Health/Juran institute 2002. truSecure Certified is a registered trademark of truSecure Corporation in the PUBLIC SECTOR SOLUTIONS, INC. united States and/or other countries.
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