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Customer Engagement for Health & Life Science

Customer Engagement for Health & Life Science

Advanced analytics to support expanded patient choice and quality of care expectations.

Solution Details

Create individualized plans that exceed patient expectations

The trend toward customer-centric operations, sweeping across most industries today, is also very evident in health and life sciences. Patients have options for care and coverage — and they now expect faster plan onboarding and claim processing, and personalized monitoring and feedback devices.

At the same time, health care ecosystems are becoming highly complex, with many different types of care and device providers. As consumers make their way through these ecosystems, don’t make them constantly reintroduce themselves.

FICO decision management solutions help you pull analytic insights in secure ways from diverse sources to create consumer-centric and disease-specific views. We put the power of decision science in the hands of business users. Working visually, they can create sophisticated engagement strategies for offering more individualized health plans or products and responding faster to marketplace and changes and patient expectations.

Use Cases


Plan Design and Eligibility

Gain more insight into what consumers want and help them find the right coverage.

Advanced analytics, including machine learning and predictive models, can discover health care consumption and payment patterns that suggest ways to improve plans. Intelligent automated processes driven by decision rules make it easy to set up plan policies, and you can use them to create automated eligibility checks and self-serve onboarding.

  • Predictive analytics
  • Business rules management

Underwriting and Claims Processing

Take less time to make better decisions.

Intelligent workflows driven by decision rules can automate underwriting for a large percentage of applications, enabling your experts to focus where they’re most needed. Claims processing systems incorporating advanced analytics save money by looking beyond the claim at hand to catch suspicious patterns of consumer or provider behavior over time.

  • Business rules management
  • Insurance fraud management

Medical Adherence

Identify patients at risk for non-compliance and make better decisions on treatment design.

Medication adherence is closely linked with clinical outcomes. As reported by the Centers for Disease Control and Prevention (CDC), one half of US patients stop taking their medications within one year of being prescribed.

Decision rules along with predictive and prescriptive models put intelligence behind leading-edge mobile monitoring devices. With the ability to analyze historical data and user profiles in combination with data streaming from the device, monitoring and measurements can respond in custom ways to each customer’s situation.

  • FICO® Medication Adherence Score
  • Streaming data analytics platform
  • Business rules management
  • Streaming data analytics
  • Rapid design/deploy of analytics-driven digital applications


Drive growth with well-targeted omni-channel campaigns.

Digital marketing systems let you quickly bring together data from both online and offline sources for targeted, personalized, rules-driven automated campaigns across customer-preferred channels. Decision rules can also enforce regulatory compliance, calculate sales compensation and validate contracts.

  • Omni-channel digital marketing
  • Business rules management
  • Rapid design/deploy of analytics-driven digital applications


Prevent cyberattacks and data breaches.

Given the importance of privacy and security for health information, and the ingenuity of hackers, it’s risky to rely on traditional methods of detection that recognize only known methods (“signatures”) from previous incursions. Self-learning analytics notice abnormal behavior, even if it’s never been seen before, and thus are better able to detect new and changing threats.

  • Cybersecurity solutions