Power BI contributes to 4.5 star rating & $360MM in associated revenue

The Challenge

One of the fastest growing healthcare payer organizations in the nation was suffering from disparate data sources, large data sets, and legacy reporting systems which made it extremely difficult to provide a complete picture of all gaps in member care. Their data loads were limited at best and reporting was still manual, so by the time reports were fully generated, the data was stale. Leadership and business units were frustrated because they could not determine the impact of gap closure initiatives adversely affecting HEDIS scores.

The Conflict


A growing health insurance entity was hampered with data silos and extensive data sets making it increasingly laborious for stakeholders to identify areas of opportunity for care gap closures.

The Solution

After a brief discovery session, our team determined that by implementing a modern business intelligence (BI) reporting tool, such as Power BI, automation capabilities could easily pull together the large data sets and deliver rich visualizations showing the impact that gap closure initiatives had on their HEDIS rates. The Power BI resource would also allow for infinite refresh proficiencies and would not require hours to create each time.

Via a Proof of Concept (POC), we showcased Power BI’s low-cost initiation, user friendly and intuitive applications, adjustable levels of permission, and shareability. Once buy-in was accomplished, our expert Power BI developers were able to consolidate all the necessary source data into several dashboards. We also provided customized Power BI trainings for all business users to ease the transition from their legacy reporting system.


Implement a modern data visualization tool to consolidate large data sets into convenient dashboards for the purpose of improving the organization’s HEDIS score.

The Result

Power BI dashboards were created that could parse the numerator and denominator information in a variety of ways allowing for new avenues of analysis.

Now, users were able to clearly identify the impact of gap closure initiatives, and track members over time. The dashboard allowed the quick identification of areas that needed improvement, including provider, geographic, and line of business analyses down to the member and sub-measure level. Trending year-over-year was available in an automated way for the first time ever.

Utilization of these dashboards, along with the gap closure initiatives, directly impacted an increase from 4 to 4.5 stars for several products adding $360 million in associated revenue.

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