1. B u s i ne s s inte ll igence: t ext An Aly tics
Identifying the True Voice of the Beneficiary
The Centers for Medicare & Medicaid Services (CMS) Addressing current challenges with Advanced text
Beneficiary Contact Center (BCC) receives communications Analytics
through various channels including phone calls, emails, web
As one practical example, CMS needs to analyze the full breadth
chats, and written correspondence. In all of these communication
of data on Beneficiary complaints about the Medicare Prescription
channels, data surrounding the interaction between CMS and a
Drug Program (PDP) and its providers. Currently, Beneficiary
Beneficiary is captured as free form text that cannot be readily
complaints are captured as free-form text in CSR comment fields
analyzed and understood.
and stored in the CMS Next Generation Desktop (NGD) data
repositories. Without the use of a text analytics process and
Free form text, or unstructured text, is text that is not organized
technology, CMS is unable to easily, consistently and accurately
in a formal construct such as a table, row, or column like data
determine and report on root causes of PDP Beneficiary complaints
that is modeled in a data warehouse. In fact, Gartner estimates
or identify any trends concerning particular Medicare plan
that over 80% of an organization’s data is unstructured text1.
providers, specific prescription drugs, or specific pharmacies.
understanding the Beneficiary today At a high-level, a properly implemented text analytics solution
Currently, CMS cannot easily gain significant insight into the provides:
interaction between the Customer Service Representatives
Proactive notification of emerging issues and potential problems
(CSR) and Beneficiaries when such a large amount of
• Enhances BI capabilities of the NDW by providing a process
information is captured as free form text. The existing process
to extract unstructured text from a file, database or other
involves manually reading through all of the unstructured text in
source to analyze and categorize the data based upon
order to effectively identify, analyze, and report on tangible or
CMS-defined business rules, providing better, richer data;
potential Beneficiary needs across the millions of interactions
• Detects issues Beneficiaries have with the service they
that Beneficiaries have with the BCC each year.
receive from the BCC, or with Medicare as a whole, before
Without an adequate process by which to capture, store, and they become widespread;
analyze all the types of unstructured data that CMS’ National • Analyzes unstructured, free-form text to identify trends and
Data Warehouse (NDW) receives it is difficult, and at times events for early warning, threat prevention, and cost
impossible, to identify current and potential Beneficiary service savings.
issues at the BCC. Without this information, it also becomes
increasingly difficult for CMS to proactively identify Beneficiary Rapid identification of trends and business opportunities
needs and take appropriate action to maintain or increase • Shortens the cycle time needed for the detection and
Beneficiary satisfaction and BCC performance. With a proven correction of issues that are identified and fuels advanced
implementation methodology, however CMS can benefit from business intelligence, such as predictive analytics;
the use of a text analytics tool, such as Clarabridge, Autonomy, • Provides insight into the business and technical process
or Inxight, to gain insight into the “Voice of the Beneficiary” improvements and problems identified in the CSR
that is found in the unstructured text of the NDW. comments/feedback that are entered into NGD;
• Provides answers to business questions that are only
found in free-form text.
1
SearchDataManagement.com article, Nov. 27, 2006

2. WHITEPAPER | Identifying the True Voice of the Beneficiary
New Existing
Call Center and Medicare Blogs National Data Warehouse
Text Analytics Tool Reporting Tool
360o View of the Beneficiary
Mymedicare.gov Beneficiary
WebChat Sessions Beneficiary Correspondence Satisfaction Surveys
Call Data to the BCC
Improved*
Accurate assessment of performance and results drivers the Best Approach to creating a 360-Degree View of the
• Reduces the level of effort required to review the feedback Beneficiary
that comes directly from the Beneficiary;
CMS should leverage the CadenceQuest Imagine methodology
• Increases visibility into the overall Beneficiary interaction
to implement a commercial-off-the-shelf (COTS) text analytics tool
lifecycle through the Beneficiary’s comments from several
and create a process by which to develop reports and conduct
internal and external data sources;
analysis upon the unstructured data that is found in the NDW.
• Eliminates the manual effort required to search for keywords
The CadenceQuest Imagine methodology captures best
in the text, thus increasing productivity for business analysts
practices and is rooted in the integration of structured and
and allowing them to focus exclusively on analysis;
unstructured data, helping organizations obtain a complete
• Generates a better understanding of Beneficiary needs and
picture of their business.
experiences resulting in improved customer satisfaction.
The text analytics process will not require any changes to the
Options to Better understand the Beneficiary NDW standard operating procedures, and only will pull existing
data from the NDW, then process and convert this data via an
CMS has a few options to fully understand the beneficiary. The
automated process built into the COTS software. Additional
first option would be to have CMS business analysts gather
value would be gained by identifying any other sources of
and analyze the information manually. Given the volume of
relevant unstructured data, such as blogs on contact center or
information, it is plausible that 12 analysts spend 3 hours a
Medicare related subjects, to further expand insight into the
day just reading the text, working out to roughly 9000 hours
beneficiary experience.
(or 4.5 FTEs) spent before any analysis is even conducted.
Second would be to continue to use a third party research The text analytics process will enhance the NDW’s existing
company to assist in understanding the “Voice of the analytical and reporting capabilities. CadenceQuest jumpstarts
Beneficiary” by manually reading and coding reports, which the implementation of such software because the majority of
is both an expensive and time consuming process. Finally, work for the first two phases of our methodology (Evaluate and
CMS could implement a text analytics solution based upon the Validate) have already been performed via support for the
CadenceQuest Imagine methodology to minimize costs and contracts in the CMS Office of Beneficary Information Services.
increase the sources and accuracy of information to best target Utilizing CadenceQuest Imagine, CMS will obtain a 360-degree
their limited resources to serve the constituency. view of the Beneficiaries desires, emotions and future behaviors,
and ultimately, will quantify the “Voice of the Beneficiary.”
About cadenceQuest government solutions
CadenceQuest Government Solutions improves mission performance by enabling transparency and empowering government decision-makers to act on timely,
consumable information. CadenceQuest is an SBA certified small business that provides strategic performance management and business intelligence solutions
in the Federal marketplace. The CadenceQuest team has engaged in highly visible projects at the U.S. House of Representatives, Department of Education, and
the Centers for Medicare and Medicaid Services. CadenceQuest is a GSA schedule holder, GS-35F-0117V.
For more information, please visit us at gov.cadencequest.com.
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