Ensure Compliance, Prevent Fraud, Improve Quality of Health and Human Services

The Informatica solution for state and local health and human services (HHS) agencies breaks down data silos and ensures that all data is trustworthy, actionable, and authoritative to ensure compliance, prevent fraud, and improve quality of services. With this solution, your HHS agency can cross-reference client histories, identify suspicious patterns of activity, flag urgent cases for faster attention across providers, and meet reporting, data security, and client privacy requirements.

  • Detect and prevent fraud and abuse by verifying identities and eligibility for services while monitoring all transactions and maintaining audit trails
  • Streamline case, inventory, asset, and facilities management by integrating data across providers
  • Improve quality of care and services by improving data quality
  • Ensure compliance and minimize risk by making certain that data is timely, accurate, secure, and stored in the appropriate formats for reporting and auditing

State and Local Health and Human Services Challenges

HHS agencies must stretch limited resources to meet growing demands for services. These agencies need to identify who is eligible for which services. They must detect, prevent, and recover costs of fraud and abuse. They need to find and eliminate inefficiencies and redundancies without sacrificing the quality of the end results. The data that HHS agencies need is often spread across applications and even across agencies, resulting in:

  • Inability to ensure that funds and resources are used legitimately
  • Inefficient case management across systems and providers
  • High risk of noncompliance with regulatory requirements

Informatica Solution for Health and Human Services Key Features

  • Accesses all data from arcane mainframe systems, relational databases and applications, Excel spreadsheets, Word documents, and PDFs—without having to develop costly custom data access programs
  • Integrates all data—from a single record to millions of records—and removes inconsistencies and duplications, then delivers that data to any system in any context
  • Profiles data to deliver a complete and completely accurate picture of the content, quality, and structure of data so that data quality issues can be resolved
  • Conducts high-precision, high-performance searches on identity data to find matches accurately and quickly, regardless of language, structure, format, location, duplication, omissions, or errors, to cross-reference clients' histories more easily and accurately
  • Creates a common set of master data across multiple domains
  • Enables agencies to monitor, correlate, and detect certain events and set alerts to identify potential fraud