State of Illinois

Bull Services Business Intelligence Solution
Helps Department of Public Aid Achieve Health Care Goals

A Bull Services Business Intelligence data warehouse solution is helping the Illinois Department of Public Aid (IDPA) advance the state’s ambitious health care goals.   Containing more than two billion records, and offering IDPA the ability to conduct advanced analytics, data mining, and decision support, the BI solution has made Illinois a national leader in health care delivery and helped the State realize more than $1 billion in ROI.

IDPA is one of the State’s largest and most critical agencies, managing more than $9 billion in funds and providing medical services for the State’s neediest citizens – including children – under the Medicaid umbrella. The BI data warehouse enables IDPA with the ability to conduct in-depth analysis on its health programs in a single integrated environment.

Illinois procured its BI solution to reduce inquiry time and help maintain the accuracy, consistency, and understanding of Medicaid data.   Another objective was to improve the efficiency of existing efforts to detect fraud and abuse, and to help in the monitoring of quality of care – including the medical necessity of specific services based on standard medical protocols.

The BI data warehouse also provides analytic functionality to support reimbursement and rate setting, budgeting, long-term analysis, ad-hoc queries, and forecasting of health care service utilization.

All of these capabilities have helped IDPA achieve outstanding results, including:

• The launching of a first-in-the-nation prescription drug program for senior citizens, called SeniorCare, which required a federal waiver that the state could only obtain through the detailed, comprehensive analysis of data that the BI system provided.   The state estimated that the five-year waiver was worth more than $800 million in federal funds and would produce a net savings to Illinois exceeding $100 million.
• The development of another first-in-the-nation provider assessment plan for its hospitals as part of its special finance restructuring that resulted in an additional $430 million infusion of federal funds.   This governor-led initiative required the State to supply the Centers for Medicare and Medicaid Services (CMS) with extensive analytics, and would not have been possible with a rigid, pre-packaged product that would not have had the flexibility to create the provider assessment plan.  
• On an ongoing basis, the BI system has helped Illinois save more than $15 million annually by identifying over-prescribed drugs; more than $4.5 million in transportation fraud; $6 million annually in DRG upcoding; and a savings in human resources that is “impossible to quantify” according to an Illinois Medicaid analyst.

Without the BI solution, virtually none of these savings would be possible; IDPA would not have been able to conduct the in-depth analyses required.   Using this advanced technology, IDPA has been able to improve the quality of life for Illinois citizens and dramatically reduce the burden on state taxpayers.