Business Intelligence Solutions for Healthcare Payers - MicroStrategy

Business Intelligence Solutions
for Healthcare Payers
MOBILE INTELLIGENCE

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Leader in Business Intelligence For Over 20 years
Largest independent public BI vendor
(NASDAQ: MSTR)
20-year focus on BI software
for the largest databases
Millions of business users at over 3,600
organizations and 20 industries in 23
countries

Healthcare Payers Success Stories
Providing Insight into Benefit
Costs and Business Intelligence
Best Practices
Founded in 1938, the Hawaii Medical Service Association (HMSA) is a nonprofit, mutual
benefit society and a member of the Blue Cross and Blue Shield Association. Nationally,
HMSA and 38 other Blue Cross and Blue Shield plans provide worldwide coverage to more
than 98 million members. Standardized on MicroStrategy since 2001, HMSA is expanding its
MicroStrategy deployment to include MicroStrategy Report Services and has purchased a
new subscription to MicroStrategy’s Technical Advisory Services, a program that enables its
subscribers to tap into best practices in business intelligence. Against a multi-terabyte IBM
DB2 database, healthcare and financial analysts utilize the MicroStrategy platform to track and
assess business data across clinical and financial areas to provide users with greater insight into
the company’s benefit costs.
Flexible Reporting for
Cost-Containment Solutions
Formed in 1976 and based in Tampa, Fla., PMSI-Tmesys is one of the nation’s leading
providers of cost-containment solutions for pharmacy and specialty services in the workers’
compensation and catastrophic injury markets. PMSI-Tmesys clients can generate user-
friendly reports on medications prescribed to a particular claimant, top-prescribed drugs, top
dispensing pharmacies, and payer-specific savings, among other criteria. Using MicroStrategy,
the users have the flexibility to drill down into the data, analyze it, export it, customize it, and
present it in a number of different ways. Previously, PMSI-Tmesys clients received monthly
reports via e-mail, with little control over the frequency and appearance of the reports.
CMS
Offering Transparency into
Medicare Spending Data on
40 Million Hospital Admissions
The information dashboard launched by the Centers for Medicare & Medicaid Services
(CMS) is powered by MicroStrategy. The CMS dashboard offers an exciting tool in support of
President Obama’s initiative for transparency and open government. In addition to providing
the American public with detailed insights into Medicare spending, the dashboard data can be
used by government and industry to assess health care policies, improve the management of
health care, and identify areas for change. With data from over 40 million hospital payments,
the dashboard enables the public to view the relationships between cost and volume of
Medicare admissions by State, starting in January 2006. Every month, the data will be updated
with nearly one million more admissions.
Enhanced Visibility Into Financial,
Operational, and Clinical Performance
The Advisory Board Company is the leading worldwide health care research and professional
services firm serving more than 2,600 hospitals, health systems, and healthcare insurers. The
Advisory Board provides multiple, hosted business intelligence applications, each focusing on
a distinct area critical to hospital margin and clinical improvement and each leveraging the
Advisory Board’s deep industry expertise. There are currently thousands of individual users –
from CFOs to business analysts – accessing the applications on a daily basis.
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Leverages Data Assets with MicroStrategy BI Deployment
Executive Summary
Health plans have long struggled to develop and
operationalize a Business Intelligence (BI) strategy.
Burdened with multiple BI applications as well as
healthcare-specific analytic applications, health plans
have struggled to create the single source of truth
and extend access to information for managers and
executives. The inability to leverage data across a health
plan has led to decision making that lacks evidence.
Harvard Pilgrim has successfully built an Enterprise
Data Warehouse that includes all available data
and has increased access to that information across
the enterprise through the use of MicroStrategy BI
technology. Managers and executives are making better
decisions more quickly than in the past which will only
become more important as competition continues to
increase and strategic and tactical decisions become
more significant.
The Challenge
Harvard Pilgrim Health Care provides a variety of benefit
options and funding arrangements to more than one
million members throughout Massachusetts, Maine, and
New Hampshire. Its mission is to improve the health of
the people they serve and the health of society. Harvard
Pilgrim is the #1 private health plan in America according
to an annual ranking of the nation’s best health plans by
the National Committee for Quality Assurance (NCQA)*.
Harvard Pilgrim is the only private health plan in the nation
to be named #1 for member satisfaction and quality of
care for seven consecutive years.**
Prior to building a comprehensive and robust Enterprise
Data Warehouse, Harvard Pilgrim’s reporting requirements
were met through a claim-centric data warehouse and
the use of SAS and SQL data access tools. Finance’s 60
analysts were the only business unit that had access
to the warehouse. Other departments made requests
for information to the Finance Department or relied on
production reports that were scheduled. Analysts were able
to change parameters but lacked ad hoc query capability.
The Process
Harvard Pilgrim convened a cross-enterprise committee
to assess BI technology. Membership on that committee
included finance, provider and network relations, customer
service, and care management departments, as well
as representatives from the technical architecture and
EDW staffs. The committee identified evaluation criteria,
including ability to access multiple data sources, richness
of data presentation capabilities, ease of use, and technical
reliability. MicroStrategy (www.microstrategy.com) was
the preferred solution on the part of both business and
technical representatives.
* NCQA’s Health Insurance Plan Rankings 2010-11 – Private
Implementation
The initial implementation was for Employer Analytics
which includes both external and internal access to the
EDW. Employer Analytics has been available for 18 months
and between 2,000 and 2,500 reports are run weekly.
Employers and brokers are using the data to watch their
medical utilization and costs which helps them to budget
their medical expenses (most large employers are selfinsured)
and make decisions on what care and wellness
programs might be beneficial to their employees. Harvard
Pilgrim has deployed the MicroStrategy technology to five
internal departments and has two additional business units
awaiting implementation.
Future Focus
Harvard Pilgrim has two future objectives. The first
is to continue meeting the analytic needs of existing
departments as well as expand the capability into other
departments. The second priority is to move the company
closer to identifying key performance indicators which
will be used to populate dashboards and more effectively
use visualization tools. Having a strong and maturing BI
capability within Harvard Pilgrim positions the company to
move rapidly toward more sophisticated tools and analyses.
Within a few months Harvard Pilgrim will deploy a provider
dashboard which will be available to providers as well as to
internal analysts. This deployment will be the first initiative
to use dashboards and will lead the way to future use of
complex analytic methodologies.
Harvard Pilgrim’s investment in BI technology infrastructure,
domain expertise and an ever expanding number of
stakeholders with access to critical information positions
the company for future competitive differentiation.
** U.S. News/NCQA America’s Best Health Insurance Plans 2005-2009 (annual). America’s Best Health Insurance Plans is a trademark of U.S.News & World Report. NCQA
The State of Health Care Quality 2004.

Solutions for Healthcare Payers – Cost of Care Analysis
Cost of Care Analysis
Actionable Insights to Manage
Medical Costs
Health plans must always monitor their key
medical expense trends. MicroStrategy, with
Cobalt Talon, can rapidly enable mobile and
web analytics. This enables your health plan to
monitor expenses at the member, group, and
disease grouping level, and
take action.
Mobile access to these key indicators allows
executives to always be in step with utilization and
expense variations. From their mobile device, users
can easily drill into clinical categories (groupers)
to identify the providers and members claim
level detail. Plans can also embed predictive risk
scores, at the member level, to enable clinical
interventions and support member engagement.
TM
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MOBILE INTELLIGENCE
Cobalt
alon
Cobalt
alon
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Solutions for Healthcare Payers – Claims Performance Management
Claims Performance Management
Mobile Access to Manage Your Cost
Ratios During the ICD10 Transaction
Claims management is critical to managing a health
plan’s administrative expense. Quick and efficient
claims processing increases provider and member
satisfaction, optimizes settlements, and minimizes
expenses. Analyzing and proactively managing the
end-to-end process across regions, claim systems,
product lines, and business units helps insurance
companies better understand their most critical
components in operational effectiveness
and member retention.
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Solutions for Healthcare Payers – Care Management
Care Management & Member 360˚
Comprehensive Access to Member Data
Care management programs are created to appropriately
manage health resources and improve member wellness.
Successful Care Management programs depend on
a health plan’s ability to connect data sources across
organizational boundaries. MicroStrategy enables the
health plan to bring together these data sets – medical
and pharmacy claims, membership and eligibility data,
contracts, case management and health risk assessment.
This allows a plan to monitor chronic disease programs as
well as achieve a 360˚ view of their members.
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Solutions for Healthcare Payers – Patient Centered Medical Home
Patient Centered Medical Home
Mobile Access to Quality Measures for
your providers and your network teams.
The PCMH model stands to be a crucial part of healthcare
reform – one that rewards quality, not quantity, of
care. Successful PCMHs have the ability to monitor
and report on key quality measures around access to
and effectiveness of care, physician engagement and
appropriate use of services.
MicroStrategy enables the PCMH team to efficiently and
effectively manage their patient population by providing
access to accurate and updated patient data across care
settings and over time. This allows providers to take
actions that result in decreased duplication of services,
lowered hospitalization rates, and improved quality of
care and patient outcomes.
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Enables Health Plans to Capitalize on These Four Megatrends trends
• Physicians and Members
are demanding
information on their
phones, tablets
• Securely access your
claim, membership and
quality data anywhere,
any time
• Rapidly launch your ACO and PCMH pilot
programs with low risk and low costs
CLOUD
• Rapidly deploy new analytic models
for PCMH, ACO with our secure cloud
infrastructure
BIG DATA
• Massive clinical data sets being made
available through ACO’s and PCMH
• Rapidly explore for cost and utilization
patterns in data with Visual Insight
HEALTH
MOBILE SOCIAL
PLANS
CLOUD
• Individual markets,
including younger,
tech savvy, will expand
through HIE’s
• Deploy Facebook apps
to inform and engage
members and prospective
members
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MicroStrategy is the High Performance Leader
BIG DATA
MicroStrategy’s Latest Software
Release Delivers More than
6 Times Greater Capacity with
3 Times Faster response Time.
Vienna, VA, March 1, 2011
Latest MicroStrategy’s
Release Delivers
average response times
under 2 seconds.
Vienna, VA, March 1, 2011
With its new high performance
initiatives, MicroStratgy plans to:
Deliver up to 10x faster
BI applications.
Vienna, VA, April 7, 2010
Latest Benchmark Test Show
MicroStrategy Mobile for iPhone
can support approx. 42,000 active
iPhone users, delivering
average response times as fast
as 1.6 seconds.
Vienna, VA, March 1, 2011

Explore and Understand Data Without Assistance from IT
BIG DATA
Visual Insight
30 Minutes with Low IT Involvement
Traditional BI
30 days with High IT Involvement
Visual Insight TM
Visual Insight enables end users to explore Big Data
and spot Trends on their own quickly, eliminating the need for IT.
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MicroStrategy Mobile Apps Combine Three Core Capabilities
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MOBILE
Intelligence Transactions Multimedia
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Close
Table Win GAMING
350K
300K
250K
200K
150K
100K
50K
3M 6M 12M
Casino Analysis
Dec Jan Feb
2/13/2011
Yesterday
EBITDA
YSTR LY
EBITDA $299,663 (7.6%)
Revenue $427,896 (2.1%)
Expenses
GAMING
$128,233 13.9%
YSTR LY
Revenue $374,285 1.4%
Table Win $182,307 (17.1%)
Table Drop $902,677 39.6%
Table Hold % 20% (13.8%)
Slot Win $191,978 28.5%
Slot Coin In $3,359,213 37.7%
Slot Hold %
PLAYERS
6% (0.4%)
YSTR LY
Rated Players 666 35.6%
Gaming Theo $308,066
HOTEL
29.5%
YSTR LY
Revenue $53,610 (20.9%)
ADR $242 0.3%
RevPAR $208 5.6%
Booking 82 0.0%
EXPENSES
YSTR LY
Promotions $2,614 4.2%
Events $1,845 4.2%
Others $123,774 14.3%
Sections i
Platform
Approach
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• No Coding or Technical Skill Required
• More Apps in Less Time
• Enterprise-caliber: Performance, Security, Scalability

Enhance and Extend Your Existing Operational Systems
MOBILE
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Introducing Transactional Apps
Building Transactions into Your Mobile Apps. Build mobile transactional apps to trigger new
business processes, reallocate resources, and accelerate business activity. MicroStrategy Transaction
Services lets you embed write-back functionality into documents and dashboards for the purposes
of decision-making or initiating a transaction.
Use Touch-Based Inputs. Use a wide range of transactional input forms and take advantage of a
flexible drag-and-drop design template. Change or add new data using: Text Inputs, Number Inputs,
Calendar, Camera, GPS, Switches, Steppers, and Sliders.
Connect to Your Existing
Operational Systems
Read from and write to any ERP system
with Web services. MicroStrategy's mobile
transactional capabilities connect to your
existing operational systems, including:
Oracle E-Business Suite
SAP
salesforce.com,
Oracle JD Edwards
EnterpriseOne
Siebel
PeopleSoft
MicroSoft SharePoint
Primavera
Microsoft Dynamics
Transact with any data source using either
xQuery for Web Services and SQL for
database transactions, such as:
Finance/Accounting
Human Resources
Manufacturing
Supply Chain
Management
Project Management
CRM
Data Services
Social Networks
Access Control
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From Insight to Action
MOBILE
Mobile Transactions are Better
Than Personal or Web Transactions.
Transactions in mobile apps provide the most
convenient access you've ever had to making
decisions and keeping the business moving.
Now any purchasing, transferring, approving,
or denying capability is convenient, always
on, and delivered to a device which is always
kept within arm’s reach. Transactional mobile
apps also provide unmatched security and
monitoring compared to cash, credit cards,
or Web transactions.
Mobile transactional apps are:
Mobile Transactional Apps. Convenient. Secure. Auditable.
• Always Available. Approve purchase orders
while you wait for the elevator.
• Secure. Authenticate who you are, wipe
access if lost or stolen.
• Content Aware. Incorporate GPS, bar code,
location awareness, NFC.
• Auditable. 360˚ activity record, provides an
audit trail.
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MicroStrategy Cloud
CLOUD
Quicker
Faster time to market, more
flexible, easier to buy, quicker
to deploy
Higher
Performance
Architected and continuously
optimized for speed and
scalability
Less
Expensive
No up-front capital
expenditure, five year total
cost advantage
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Faster Availability = Faster Time to Value
16
CLOUD
Plan > Source> Build> Deploy
Generic Cloud
Plan Source Build Deploy
On Premises
Plan Source Build Deploy
Time
Single source
Pre-architected
No software
No hardware
48 hour availability

Why You Should Use MicroStrategy Cloud
CLOUD
$100M Investment in
World Class Performance
Hardware, Software, Networks, Facilities
World-class Experts
Executives, Architects, Designers, Operators
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No Capital Expenditures and Five Year Cost Advantage
18
CLOUD
Save Millions up front. No financial risk. More project flexibility.
NO HARDWARE
NO FACILITIES
NO
IMPLEMENTATION
RISK
NO SOFTWARE
NO SETUP &
CONFIGURATION
NO LONG
IT PROCESS
Millions
$5
$4
$3
$2
$1
$0
MicroStrategy
Cloud
Application
Development
Facilities
Operations
Hardware
Software
Application
Development
MicroStrategy Cloud On-Premises
MicroStrategy Cloud vs. On-Premises 200 User System Over 5 Years

Enterprises Must Embrace the Social Phenomenon Because…
SOCIAL
It’s Where All
the People Are
Facebook Users
750M Total Users
Facebook Attention
62 Min. / Day
Facebook Traffic
38% of all Web Page Visits Are
from Links on Facebook
It’s Where All the
Personal Data is
Friends
Interests Demographics
Events
Age
Gender
Orientation
Marital
Etc.
It’s Where All the
Connections Are
Each of 750M People
Connect With
130 People
80 Groups & Events
9 Favorite Brands
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MicroStrategy Gateway for Facebook
20
SOCIAL
Gateway
YOUR ENTERPRISE
Harness the Power of Facebook Data and Improve Your Business

The MicroStrategy Gateway Analyzes the Facebook Social Graph
SOCIAL
Your Members Facebook Apps
facebook
Allows your health plan to
Identify, engage & market products to prospective
individual policy buyers in new social medium
Be rapidly alerted to negative social media feedback
on your brand, allowing you to respond quickly
Re-invent your underwriting by harnessing your
medical spend data w/ new demographic attributes
Facebook
Relational
Data
• Greater History of Data
• Sophisticated Query
• Deeper Analytics
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Partners in Healthcare Payers Solutions
Strong Partnerships with Over 200 World-Class Providers
PMS 200 Red
PMS 424 Gray
The Data Virtualization Gold Standard
TM
System Integrators
Applications
Database / Technology
The business intelligence experts.
Cobalt
Found from website
Modify PMS
alon

What MicroStrategy Healthcare Customers are Saying: The Buzz
Helping Payers Reach Top Tier
Performance
Our research shows that top performing organizations separate
themselves from their peers by their ability to quickly diagnose the
root cause of recurring problems and issues and spend time not on
diagnosis but on driving to solutions. Our business intelligence
membership programs -- which include our distinctive
business intelligence tools on MicroStrategy’s platform as
well as our best practice research and domain expertise
to drive ongoing improvement -- really help our member
hospitals reach and maintain the top tier of performance.
- The Advisory Board
Creating Applications for Quick
Decision Making
Our experience selecting MicroStrategy and working with
them to build the app has been fantastic.
Better, More Insightful Research
In the Fight Against Cancer
We selected MicroStrategy because of its exceptional scalability, core
reporting, and analytic functionality. MicroStrategy positions is
to provide better quality and more timely information to our
clients, giving them critical insights to make analytically
based decisions.
- Novation
- PMSI–Tmesys
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Copyright Information
All Contents Copyright © 2011 MicroStrategy Incorporated. All Rights Reserved.
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Patent Information
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This product is patented. One or more of the following patents may apply to the product sold herein: U.S. Patent Nos. 6,154,766, 6,173,310, 6,260,050, 6,263,051, 6,269,393, 6,279,033, 6,567,796, 6,587,547, 6,606,596, 6,658,093, 6,658,432, 6,662,195, 6,671,715, 6,691,100, 6,694,316, 6,697,808, 6,704,723, 6,741,980, 6,765,997, 6,768,788,
6,772,137, 6,788,768, 6,798,867, 6,801,910, 6,820,073, 6,829,334, 6,836,537, 6,850,603, 6,859,798, 6,873,693, 6,885,734, 6,940,953, 6,964,012, 6,977,992, 6,996,568, 6,996,569, 7,003,512, 7,010,518, 7,016,480, 7,020,251, 7,039,165, 7,082,422, 7,113,993, 7,127,403, 7,174,349, 7,181,417, 7,194,457, 7,197,461, 7,228,303, 7,260,577, 7,266,181,
7,272,212, 7,302,639, 7,324,942, 7,330,847, 7,340,040, 7,356,758, 7,356,840, 7,415,438, 7,428,302, 7,430,562, 7,440,898, 7,486,780, 7,509,671, 7,516,181, 7,559,048, 7,574,376, 7,617,201, 7,725,811, 7,801,967, 7,836,178, 7,861,161, 7,861,253, 7,881,443, 7,925,616, 7,945,584 and 7,970,782. Other patent applications are pending.
MicroStrategy Incorporated • 1850 Towers Crescent Plaza • Tysons Corner, VA 22182 • 1.888.537.8135 • www.microstrategy.com
Copyright ©2011. All rights reserved.
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