Case Study: Tsunami Health
Building a Data-Driven Reporting Suite for the Health Insurance Industry
The Challenge
The health insurance industry—including insurers, brokers, and large self-insured clients—faces a significant challenge in navigating a complex landscape of data. Key public data sources from the Department of Health and Human Services (HHS), as well as other public health organizations, contain critical information on healthcare costs, quality, and trends. However, this data is often disparate, difficult to access, and lacks a cohesive structure. The challenge was to integrate this public data with proprietary client-specific metrics to create a unified, actionable reporting suite. The goal was to provide a powerful tool for strategic decision-making in plan design, network optimization, and cost management.
Our Solution: A Unified Data Strategy
Dux Prana developed a comprehensive, three-part solution to create a seamless reporting workflow. The core of our strategy was to centralize diverse public and proprietary data sources into a single, dynamic dashboard built in Google Looker Studio.
Public Data Integration (HHS): The primary step was to programmatically connect to and ingest data from key public sources. We focused on data sets from HHS related to healthcare spending, provider quality scores, and demographic health trends. We also integrated data from other public health organizations to provide a broader context. This data was systematically cleaned, transformed, and loaded into a structured data warehouse (a Google Sheet or a more robust solution like BigQuery, depending on scale), ensuring it was ready for analysis.
Harmonizing Client-Specific Data: The client's own proprietary data—such as claims data, utilization rates, member demographics, and premium information—was crucial for a complete picture. This data, often housed in internal systems, was also integrated into our centralized data warehouse. This process allowed us to cross-reference public trends with a client's specific performance, providing a unique and powerful perspective.
The Looker Studio Dashboard: This became the central nervous system of the reporting suite. We used Looker Studio's data blending capabilities to merge the public and proprietary data sets. This allowed us to create a truly holistic dashboard that showed:
Cost & Utilization Analysis: A clear view of spending by service, provider, and member demographic.
Network Performance: Dashboards comparing the client's provider network performance to broader industry and regional averages, using HHS data.
Plan Design Insights: A single panel displaying the impact of different plan designs on member behavior and costs, benchmarked against national trends.
Key Performance Indicators (KPIs): A single panel displaying all critical KPIs like cost-per-member, utilization rates, and a comparison of in-network vs. out-of-network spending.
The Results
The unified reporting suite delivered immediate and tangible value to insurers, brokers, and self-insured clients.
Actionable Insights: By seeing all metrics in a single dashboard, clients could instantly identify trends. For example, a large self-insured employer discovered that their mental health claims costs were significantly higher than the national average, prompting them to revise their employee wellness program and benefit design.
Reduced Manual Effort: The automated data feeds from public sources and the streamlined client data integration drastically reduced the time spent on manual reporting. Teams now spend less time on data aggregation and more on strategic analysis.
Empowered Stakeholders: The easy-to-read, interactive dashboard empowered stakeholders at every level to understand the data, without needing technical expertise. The clean design and consistent visual language fostered a culture of data-driven decision-making, leading to more informed negotiations with providers and smarter plan offerings.
The project transformed the reporting process from a time-consuming, fragmented chore into a streamlined, strategic asset for the health insurance industry.