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Avalon: Providing
cloud-based lab reviews
at lightning speed
Overview
Accenture built a first-of-its-kind
platform on the public cloud for
Avalon Healthcare Solutions,
helping payers reduce
unnecessary lab spend
while maintaining
quality care.
Copyright © 2016 Accenture All rights reserved.
Client profile
Copyright © 2016 Accenture All rights reserved.
Avalon Healthcare
Solutions
•  Laboratory benefit management
Company founded in 2013
•  Headquartered in Tampa, Florida
•  Helps health payers manage the
cost and effective use of diagnostic
lab tests
•  Assesses lab charges within end-to-
end claims review process
6
Project
objectives
Avalon sought to accelerate service
delivery using a cloud solution
Chose Accenture for:
Copyright © 2016 Accenture All rights reserved.
Deep knowledge of
the healthcare
industry
Technology skills Cloud-based
solutions
Partnership with
Amazon Web
Services (AWS)
through Accenture
AWS Business
Group (AABG)
Copyright © 2016 Accenture All rights reserved. 1. The Health Insurance Portability and Accountability Act (HIPAA) took effect in 2003.
AWS cloud has history of
secure operations, essential for
complying with health privacy
guidelines.1
9
Opportunity
Copyright © 2016 Accenture All rights reserved. 2. G2 Intelligence 2010; Francisco Partners analysis.
In the U.S.,
8+ billion lab tests
performed annually
30+ percent
overused or unnecessary2
Initially, Accenture helped Avalon
weigh go-to-market options
Avalon chose cloud-based platform vs. high cost
of building infrastructure in-house
Solution
Copyright © 2016 Accenture All rights reserved.
AABG supported in
the architecture and
build of a 100-
percent cloud-based
Claims Editor as a
Service (CEaaS)
Accenture clinicians
assisted in the
development of 130+
laboratory policies
Business rules/
algorithms were
developed for
real-time claim
processing
New portals were
built for Avalon’s
customers to access
data, claims and
prior authorization
Copyright © 2016 Accenture All rights reserved. 2. G2 Intelligence 2010; Francisco Partners analysis.
AWS’s elasticity
supports rapid
onboarding of health
plans and claims
volume
Results
Copyright © 2016 Accenture All rights reserved.
Claims Editor as a Service (CEaaS)
cloud-based solution hosted on AWS
Edits up to 150,000
claims per hour
99 percent uptime and 99.5
percent accuracy
Response time per claim
averages less than a
second: 856 milliseconds
Copyright © 2016 Accenture All rights reserved.
Flexible: scales as demand
grows for Avalon’s services
Future proof: Easy to update
based on changing insurer
policies, research findings,
regulations
Analytics
capabilities
Copyright © 2016 Accenture All rights reserved.
Claims Editor as a
Service (CEaaS)
has built-in advanced
analytics
Avalon can mine
data for statistical
analysis based on
findings from clinical
research
Important as new lab
tests and treatments
emerge
Analytic Insights help
Avalon’s customers
save by minimizing
unnecessary lab
tests
Copyright © 2016 Accenture All rights reserved.
Thank you!
Related content:
Accenture AWS Business Group
Accenture Healthcare
Accenture Operations

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Accenture Cloud-based Lab Reviews Case Study

  • 1. Avalon: Providing cloud-based lab reviews at lightning speed
  • 3. Accenture built a first-of-its-kind platform on the public cloud for Avalon Healthcare Solutions, helping payers reduce unnecessary lab spend while maintaining quality care. Copyright © 2016 Accenture All rights reserved.
  • 5. Copyright © 2016 Accenture All rights reserved. Avalon Healthcare Solutions •  Laboratory benefit management Company founded in 2013 •  Headquartered in Tampa, Florida •  Helps health payers manage the cost and effective use of diagnostic lab tests •  Assesses lab charges within end-to- end claims review process
  • 7. Avalon sought to accelerate service delivery using a cloud solution Chose Accenture for: Copyright © 2016 Accenture All rights reserved. Deep knowledge of the healthcare industry Technology skills Cloud-based solutions Partnership with Amazon Web Services (AWS) through Accenture AWS Business Group (AABG)
  • 8. Copyright © 2016 Accenture All rights reserved. 1. The Health Insurance Portability and Accountability Act (HIPAA) took effect in 2003. AWS cloud has history of secure operations, essential for complying with health privacy guidelines.1
  • 10. Copyright © 2016 Accenture All rights reserved. 2. G2 Intelligence 2010; Francisco Partners analysis. In the U.S., 8+ billion lab tests performed annually 30+ percent overused or unnecessary2 Initially, Accenture helped Avalon weigh go-to-market options Avalon chose cloud-based platform vs. high cost of building infrastructure in-house
  • 12. Copyright © 2016 Accenture All rights reserved. AABG supported in the architecture and build of a 100- percent cloud-based Claims Editor as a Service (CEaaS) Accenture clinicians assisted in the development of 130+ laboratory policies Business rules/ algorithms were developed for real-time claim processing New portals were built for Avalon’s customers to access data, claims and prior authorization
  • 13. Copyright © 2016 Accenture All rights reserved. 2. G2 Intelligence 2010; Francisco Partners analysis. AWS’s elasticity supports rapid onboarding of health plans and claims volume
  • 15. Copyright © 2016 Accenture All rights reserved. Claims Editor as a Service (CEaaS) cloud-based solution hosted on AWS Edits up to 150,000 claims per hour 99 percent uptime and 99.5 percent accuracy Response time per claim averages less than a second: 856 milliseconds
  • 16. Copyright © 2016 Accenture All rights reserved. Flexible: scales as demand grows for Avalon’s services Future proof: Easy to update based on changing insurer policies, research findings, regulations
  • 18. Copyright © 2016 Accenture All rights reserved. Claims Editor as a Service (CEaaS) has built-in advanced analytics Avalon can mine data for statistical analysis based on findings from clinical research Important as new lab tests and treatments emerge Analytic Insights help Avalon’s customers save by minimizing unnecessary lab tests
  • 19. Copyright © 2016 Accenture All rights reserved. Thank you! Related content: Accenture AWS Business Group Accenture Healthcare Accenture Operations