Solutions to Improve Data Quality, Engagement and Fraud Prevention

Leverage data insights to understand areas of risk across health plans. 

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Reliable data and intelligence for health plan strategies and operations.

For health plans, access to robust and high-quality data and analytics are critical for success—and LexisNexis is the industry leader.
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Health Risk Models

Social determinants of health models and data attributes uncover hidden and avoidable health risks for intervention and population health management.

Member Data Management and Services

Improve engagement, outreach, marketing and compliance by aggregating, enhancing and maintaining member demographic information seamlessly.

Fraud, Waste and Abuse Detection

A suite that combines claims, provider, member and public records data with scoring and visualization for fraud and abuse prevention.

Member Identity Intelligence

Reduce identity-based risk by leveraging leading technology to confirm enrollment information and secure access to PHI with identity authentication and verification solutions.

Provider Data Management and Services

Insights on provider networks and data quality to improve directory accuracy, network contracting, and ongoing provider outreach.

Other Healthcare Capabilities

Provider

Data management and intelligence solutions improve market share, reduce risk and safeguard patient identities.

Pharmacy

Data, analytics and prescriber verification solutions help pharmacies identify ways to reduce fraud and expand market penetration.

Life Sciences

Data management and market intelligence solutions offer life sciences organizations a healthy market advantage.

Other LexisNexis Healthcare Solutions

Insights and Resources

social determinants of health
Article

Curious about social determinants of health?

Case Study

Improved Health Risk Modeling - Improved Patient Engagement Results

White Paper

The Real Cost of Healthcare Fraud -- and New Ways to Fight It

LexisNexis Risk Solutions
Press Release

LexisNexis Risk Solutions to Assist L.A. Care With Its Accurate Provider Directory

Case Study

National Health Plan Leverages LexisNexis® Data Solutions to Improve HEDIS Scores

White Paper

A Systematic Approach to Combat Healthcare Identity Fraud

Partner with LexisNexis Health Care

We believe in the power of data and analytics
to manage risk & uncover opportunity.

“With LexisNexis Socioeconomic Health Score, we can be a health action driver and help health plans identify and engage the right people to take the right actions that improve quality and reduce cost." 

Russel Benaroya, Co-Founder and CEO, EveryMove

EveryMove leverages LexisNexis to Predict Health Risk Across Marketplace Exchanges
Read The Case Study