Case Study

Discovery Health Partners: Improving Customer Experiences Through a Modernized Cloud-Native Infrastructure

By helping healthcare payers solve payment-integrity challenges improving financial and member outcomes, Discovery Health Partners had become an industry leader with a healthy growth pattern. That positive trajectory had also brought in new opportunities to create a strategic infrastructure to support their immediate and long-term growth. Discovery’s CIO sought strategic solutions that would capitalize on their existing AWS infrastructure footprint and enable them to onboard customers faster, more efficiently, and have a strong digital and data foundation for future growth, without having to completely re-build their infrastructure.

What We Did

Data architecture

Data governance

Cloud strategy & assessment

Cloud management

Operational process study

Solving Immediate Customer-Onboarding Growth Challenges, While Creating a Strategic, Long-Term Action Plan

With over $400 million recovered on their clients’ behalf, it’s not surprising that more than 60 health plans rely on Discovery’s payment and revenue-integrity services. Their continued success brought more focus on the opportunities that a streamlined, efficient technology infrastructure could enable further growth.

One of their biggest challenges was related to the legacy on-premise server application. With system performance degrading over time, Discovery took action.

Prime TSR came in with a clear objective: Enable immediate growth by identifying and remediating mission-critical performance and reliability opportunities.

Utilizing AWS’s core cloud-native infrastructure tools and services, we cleared the bottlenecks from their customer onboarding process, significantly increased the stability of their core application, and reduced wait times by several hundred man-hours per week.

Meanwhile, our business continuity plan improved recovery time and point objectives (RTO and RPO). And our prioritized road map provided strategic recommendations for future scaling.

Architecting a Best-In-Class Business Continuity Infrastructure, Powered by AWS

As Discovery Health’s business grew, decision-makers recognized the need to guarantee faster, more robust recovery in case of an outage. So they sought to strengthen disaster recovery & business-continuity capabilities.

To support both high platform availability and robust disaster-recovery infrastructure, Prime TSR made strategic architectural improvements to their data platform.

As a result, Discovery improved their business continuity while gaining the added security of a secondary database replica. Bonus: this replica is not only essential for business continuity but also useful for real-time analytics.

Building a High Performing Cloud Solution for Accelerated Growth and Improved Customer Experiences

After many years of successful business growth, Discovery Health knew that smart infrastructure decisions were just as important as efficient business-management choices. So from the start, they kept the careful focus on maximizing efficiencies, strategy, and the goal of long-term self-sufficiency.

Leveraging our proprietary performance-management methodology, Prime TSR identified performance and scalability opportunities and mapped a clear path forward. We created and executed a strategy to focus on the highest priority improvements in their data platform that would create the highest performance and business return according to our strategic cost/benefit analysis.

As we addressed high-value items, we also trained the Discovery Health team on how to tackle future priorities themselves, helping lay the groundwork for a sustainable in-house maintenance program.

As a result, Prime TSR helped improve medical claims processing time by up to 90% and extended the scalability limits of the system, ensuring alignment that would match the pace of Discovery’s healthy business growth.

Reducing operational burden by 70% through strategic automation and a data-driven assessment

Discovery Health aimed to reduce areas of waste in their processes and automation. So they enlisted Prime TSR to perform an operational process study, make recommendations, and propose a plan for improvements.

Our crew of experts shadowed the Discovery operations team, reviewed existing maintenance processes, measured time spent, compared the status quo to Prime TSR’s best practices, and identified what a “perfect world” solution might look like.

From there, we broke the big picture down into individual work items and performed a cost/benefit analysis to map out the most efficient, strategic path to implementation.

The results—which included a 70% reduction in operational burden for the platform—were hugely impactful both for database operations and overall business efficiency.

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cost reduction fueled by hundreds of weekly man-hours saved

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improvement in claims processing time

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reduction in operational burden for the data platform