unitedHealth Group ingenix Public Sector Solutions

							   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 | juliet.koback@ingenix.com
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.
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