ProClarity Helps Major Preferred
Provider Organization Enhance its Value
in Many Ways

by Proclarity Staff

If you think information analysis is important to your business, consider the plight of modern Preferred Provider Organizations (PPOs) such as Emerald Health. As Ohio’s leading premier independent PPO, the Cleveland-based company works closely with over 170 hospitals, 1,800 ancillary providers and 20,000 physician locations—negotiating, documenting, monitoring and maintaining millions of exacting and complicated relationships between payors (most often employers), providers (such as hospitals and physicians) and patients (typically employees).

"Our challenge," says President and CEO Peter Osenar, "is not just to maintain data on all these relationships, but to transform that data into valuable information."

Osenar’s assessment is confirmed by Senior Vice President of Health Economics, Deanna Weber, "Our success is driven by what we do with our data."

No wonder then that Emerald’s executives are enthused by what Osenar and Weber call "the quantum leap in information technology" recently instituted at Emerald Health.

Unprecedented Speed and Power

That quantum leap is ProClarity, an information analysis tool that’s revolutionizing the way Emerald Health does business. "We’ve always had the data," says Osenar. "The difference now is that we can change it into valuable information in time to act. Information is no longer static. It’s actionable."

According to Health Economics Data Manager, Steve Albrecht, "ProClarity garners in half an hour the information it would have taken us days or even weeks to garner before."

"Just as important as its speed, is its power," says Weber. "ProClarity enables us to understand and improve our business in ways that were previously unthinkable."

"It’s incredibly powerful," confirms Albrecht. "We’re able to delve into analysis that we couldn’t have touched prior to our use of ProClarity."

Just Two Months to Deploy

Albrecht’s job was to integrate the company’s database using Microsoft® Analysis Services™ and facilitate access to the database via ProClarity. "In just two months we were able to normalize the raw data and create standardized fact tables and dimensions," says Albrecht. "Seventy percent of our current application was developed in the first two weeks during the ProClarity® quick-start program."

How difficult was it to deploy ProClarity? "Very, very simple," says Albrecht. "We’vebeen able to convert a lot of our previous reports from other applications right into ProClarity. Now we have them all in one place."

ProClarity’s flexibility is another boon. "ProClarity lets us play around with different cubes and get entirely new ideas about out business relationships," says Osenar. "We’re not only getting faster information; we’re also getting different perspectives of the information."

Knowledge Pays

For example, says Osenar, "We very quickly learned that ProClarity could improve our internal management by giving us more quantifiable metrics than we had before." By quickly and accurately tracking expenses and margins, Emerald has been able to manage the business with more precision than ever before.

"We also use the new information to write better contracts," says Weber. "Obtaining accurate information quickly is oftentimes the difference between a good contract and a bad one."

"A good contract," remarks Osenar, "is one that not only takes into account the projected healthcare needs of the consumer, but also focuses and gives credence to what makes the most sense economically to the employer or payor while offering an equitable profit margin to our provider partners."

Demonstrating Value

Emerald Health is today a leader in the usage of information technology. A 65 percent auto-adjudication rate has enabled the company to keep a unique promise to customers: "Out the Gate in 48." While many competitors require a week or even a month to process claims, "Two days is our commitment," says Osenar, "and we’re very much on target. In fact, we are now processing 80% of our claims within 24 hours."

Emerald Health offers a variety of services to both its provider network and its payor groups, all of which makes it, in Osenar’s view, the greatest value of its kind in the marketplace. "We’re a vintage product," says the CEO. "Frankly, our goal isn’t to be the least costly alternative when it comes to providing health care. Our goal is to be a delivery system offering best-in-class quality that is cost-sensitive to the needs of our payors, providers and employees."

"ProClarity plays a key role here, too," says Weber: "By accessing the data at each facility, we can better determine utilization patterns and see where dollars are being driven. Then we can negotiate with those facilities in ways that most appropriately address their concerns regarding reimbursement while giving our clients and their employees the best economic packages possible."

A Clear Choice

One thing that appealed to Emerald Health was that they could buy ProClarity rather than lease it. And the price was right. By running revenue, expense and margins, says Osenar, "ProClarity essentially does the work of one or two top MBAs. In fact, two MBA’s couldn’t do in a month’s time what a good analyst using ProClarity can do in a week."

ProClarity’s return on investment is just beginning. "I see us using ProClarity even more aggressively than I first envisioned it," says Osenar. "I initially saw it as a quick way of demonstrating our value to our payors and corporate clients. I thought it would help us answer in detail the many questions our customers pose regarding healthcare costs. But now I see that it’s almost unlimited. I think we’re just beginning to tap ProClarity’s power."

The Best is yet to Come

Weber agrees: "We’re still very green at this and are not recognizing probably a fraction of the capability and power of this tremendous tool. There are additional areas where we’re obviously going to derive huge benefits from ProClarity."

"We have a whole separate data set for our medical management department that we haven’t even looked at yet," says Albrecht. "That data is tremendously valuable and ProClarity is the perfect solution for our Utilization Management and Case Management staff."

"Without ProClarity," says Osenar, "an entity is essentially flying blind. What we’re able to do now is truly remarkable. Not only do I feel more confident, but everyone who touches the information is empowered to make better decisions. I see a very bright future for Emerald with ProClarity, especially in healthcare’s current era of double-digit cost increases."

About ProClarity Corporation

ProClarity Corporation develops tailored analytic solutions that drive success by enabling enterprise organizations to derive the maximum business advantage from their valuable data capital. ProClarity's scalable, cost-effective analytic applications transform vast amounts of raw data on everything from sales trends to customer information into useful, context-relevant business intelligence. ProClarity analytics help such leading enterprise companies as AT&T, Compaq, Edwards Cinemas, Ericsson, GE Capital, HP, Nabisco, Nordstrom, Pfizer, AOL Time Warner and the World Bank measure, predict and optimize business performance by facilitating more collaborative work processes and ensuring decision makers make more accurate decisions. Learn more:

Angie O'Hara, ProClarity Corporation Public Relations Manager, 208.344.1630 x2133,, gave permission to use this case study at DSSResources.COM on Thursday, March 21, 2002. We contacted Mr. Peter Osenar and Mr. Steve Albrecht at Emerald Health to verify this case study. For more information check Posted April 14, 2002.

ProClarity Staff, "ProClarity Helps Major Preferred Provider Organization Enhance its Value in Many Ways", ProClarity Corp., 2002, URL DSSResources.COM.