Decorative image showing charts and analytics

Navigating health ecosystems: A payer perspective

How a team of DIA Design apprentices helped to untangle a web of healthcare data and analytics, medical coding, and health risk adjustment systems

Simplistic entity relationship diagram showing how patient data in the form of codified medical records are submitted in claims sent to government agencies (to Center for Medicare and Medicaid Services and state agencies) for Medicare reimbursement by payers.

Situation: What was the situation we faced?

Health risk adjustment platforms, including the one created by our client, can be difficult to use and not designed with an overarching strategy in mind.

Over a 6-week assessment project, DIA Design worked with Episource to develop a current state journey map of Episource products.

Payer Healthcare Analytics & Technology Solutions - Episource
Episource is simplifying healthcare. From analytics to submissions, we are reinventing the risk adjustment and quality workflow for Medicare, Commercial, and Medicaid health insurance companies.

We developed recommendations for their platform by focusing on 4 of their products and services.

Tasks: What tasks were involved in that situation?

Our main tasks were to:

We needed to figure out:

Actions: What actions did you take?

Before the project started, we researched the domain space and created an ecosystem map to understand the domain of healthcare data and analytics, Medicare reimbursement, and risk adjustment.

We brought together a team of:

to conduct the research and discovery sessions.

Over the course of 3 weeks, we met with product and engineering stakeholders to conduct product walkthroughs and demos.

Further activities included:

Result: What were the results of those actions?

As a team, we learned:

Some of our biggest learnings and takeaways as apprentices were around:

On the client side, Episource is bridging their product and engineering teams together to raise awareness and continue the work we started to cultivate customer-centric and research-driven culture in the organization.


Thank you and your team for the great case study work which established an important groundwork for us to start build a user focused and research driven design process in the organization!

~ Sungae Park, Head of Design, Episource LLC

Ecosystem Map