Page 142 - DCAP606_BUSINESS_INTELLIGENCE

Unit 9: Advanced Dimensional Design

Notes
there is a need to utilize information to predict and manage expenses, making it feasible
to provide the most comprehensive benefits packages possible to members at a reasonable
cost. PMP Inc’s Information Services Project Manager, John J. Burns, PMP describes how
the company relies on efficient access to data: “From a production point of view, we’re in
the claim adjudication business. We need to determine which type of claim or which types
of providers are submitting claims requiring the most effort to adjudicate.”
To access their data, PMP, Inc. relied on traditional reporting mechanisms and practices
which are heavily dependent on Information Services (IS) resources. John J. Burns provided
insight into the common maintenance and development of reports. “Reports that were
developed internally by IS staff or canned system reports not customized to our specific
needs were run using the same transactional database that was being used in production.
There were times when this would severely affect system performance.” This impact on
the production system was most evident at the beginning of the month, when most reports
are run, and resulted in the production system being brought to a crawl. The drain on the
IS resources was also significant due to the amount of time needed to create custom
reports or modify existing reports, decreasing the amount of time IS staff had available to
devote to other projects.
The Solution

When looking into reporting solutions, PMP, Inc. was concerned about some of the issues
associated with maintaining large sets of data in a data warehouse environment. Through
his experience with the MultiValue community, Burns was aware of MITS products and
the advanced reporting and analytics MITS Discover offered. MITS Discover presented a
way to access near real time data without need for a dedicated data warehouse. During
further review of MITS Discover Burns realized “[the] Discover hypercube concept
eliminated these concerns. We [also] anticipated that the browser-based interface would
reduce training time and combined with the ability to export directly into a spreadsheet
or Adobe PDF documents would empower the end user and not burden the limited
resources of our IS Department.”
PMP, Inc. wanted to find out what types of claims were costing the most to process and
who was filing them. Additionally, they needed to perform comparative analysis, such as
differences between geographical regions, average cost per claim type and cost per claim
by each of their submitting providers. Burns worked with a MITS Product Specialist to
design and implement their first set of Hypercubes to provide this analysis.

As a result of past experience, Burns mentioned, “often a solution based on how a product
functions is offered or even forced on a client.” He did not find this to be the case with
MITS and was impressed with the amount of time the MITS staff took to understand PMP’s
business processes and unique needs. He went on to say, “MITS took the time to thoroughly
comprehend what we hoped to accomplish and how MITS Discover could meet most of
those needs. [The MITS Product Specialist] also clearly stated what the tool was not designed
to do, and knowing that actually helped us get exactly what we required out of the design
of our Hypercubes.”
The Results
While the rollout of MITS Discover to the majority of PMP’s users is still in process, they
are currently using MITS within their Claims, Fraud and Abuse, Utilization, and IS
departments. One example of improved access to data is in their Turnaround Hypercube.
Claims have a 30 day turnaround for payment and with this Hypercube they are able to
identify where outstanding claims stand in their queue. Most claims are adjudicated

Contd....

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