Case Studies Health Care Underwriting Program Design

PAG helps medical-services client quickly build $50M loan program

medical service group loans

Predictive Analytics Group (PAG) was engaged in May 2021 by a U.S. medical-services group that provides outpatient plastic surgery, dental cosmetic surgery, and vision surgery (including Lasik). Our client wanted to offer term loans to help its customers finance these services. The client faced several challenges — multiple legacy systems whose data did not talk to each other, no data infrastructure, and little to no reporting or analytics. PAG was asked to quickly resolve this problem on a fixed monthly budget to help the client move in a more structured, data-driven manner.

PAG Solution:

PAG leveraged our internal Enterprise Data Platform, GOBLIN, to help consolidate data housed within five different systems. GOBLIN, which was built by experienced team members from the healthcare industry, is HIPPA compliant and was able to merge all five data streams into a relational database infrastructure, allowing both the client and PAG to access the full suite of data the client had acquired over the years.

Next, after passing a HIPPA audit, PAG built a robust underwriting model to help the client offer term loans to customers while managing risk and line/term assignments to help patients finance their medical expenses.

Finally, PAG built a comprehensive set of performance and monitoring reports that enable the client to manage the portfolio’s risk through monthly Corporate Risk and Pricing Committee meetings. PAG has served as an advisor on these calls for the past 12 months to help the client make informed decisions on managing its growing portfolio.

Client Benefits:

1. PAG consolidated five data streams into an easy-to-navigate, relational database used by both the client and PAG.
2. PAG helped the client pass an internal and external HIPPA audit for data privacy and information security.
3. The underwriting model exceeded Year 1 growth targets by 8% while simultaneously coming under projected losses by 5%.
4. PAG built the infrastructure for the program in less than 90 days and helped build the portfolio to $50 million in under 12 months.
5. The client has, with PAG’s assistance, hired a five-person risk department and used our initial reports to monitor the portfolio’s performance and make recommendations to senior management.

Client Satisfaction:

The client has re-engaged PAG to provide a PAG subject-matter expert for its Corporate Risk and Pricing Committee to help guide account-management strategies while ensuring that what is learned is passed back to the Underwriting team. These wins are seen in the initial book of business for future portfolio bookings.