chapter  12
7 Pages

US Health Insurance Organization: Financial Reporting Analytics with Big Data

WithMarc Perlman, Larry Manno, Shalin Saini

The Affordable Care Act (ACA) significantly changed the US healthcare system, with new demands and capabilities driving the need for advanced analytics to better manage risk, quality measures, and Health Exchanges. The ACA is designed to reform the US healthcare system by providing more Americans with expanded coverage options and rights, as well as incentives and penalties surrounding quality of care versus fee-for-service. Many health insurance organizations believe that in order to be successful, they require advanced analytics solutions, including tools for comparative and predictive analysis to better understand and manage issues around risk modeling and product structures specific to Exchanges. Deloitte assisted the US health insurance organization in capturing financial information in its raw conformity within the Enterprise Data Lake, then applied summarization and validation rules within the Data Lake to automate and improve end-user consumption across the finance and actuarial functions.