HEALTHCARE BENEFIT PLAN COST REDUCTION PROGRAM

For this service to be of great value, you must have a minimum of 2500 plan participants 

Ownership and control starts with connecting disparate data silos
We start by creating a elastic relational data warehouse, which lives in an extremely secure encrypted environment on a cloud-based portal. Each client has their own database which accepts feeds from Ben Admins and Carriers. This allows data to be blended and normalized for continuous (multi-period) in-depth data analysis and lifetime storage.

We normalize into our data warehouse 

Clinical
DESCRIBE Financial 

We show you what’s going on inside your plan today. Clinical data tied to the financial
impact to the plan

We organize data at the most basic level of healthcare analytics and then we go a step further. We show you high-level views of total block performance and drill down views at a granular level, stratifying risk to identify what each member is likely to cost the plan over the next 12 months . 

  • Gain insights of global risk factors within a population 

  • Identify historic patterns 

  • Stratify risk 

  • Identify high-cost drivers and accelerating conditions 

  • Define relationships at a granular level 

  • Define major diagnostic groups/codes 

  • Define pharmacy specialty drug costs 

Clinical
PREDICT
Financial 

Predict risk with greater accuracy to identify trends sooner in an unbiased, transparent and
cost-effective way

We predict risk more accurately and much faster than traditional methods. We construct forecast models on actual data to uncover more insights of current plan costs and future clinical risks – unprecedented detail that can be used to maintain a competitive benefits program while controlling costs. 

  • Analysis of medical & Rx claims using actuarial science 

  • Predict future trend for this disease state and the future cost 

  • Uncover future clinical risks 

  • Improve accuracy and reliability of risk projections 

  • Improve the quality of care and reduce Healthplan cost 

What If Scenarios
PRESCRIBE

Score Risk

 
We show you what’s going on inside your plan today. Clinical data tied to the financial
impact to the plan 

We organize data at the most basic level of healthcare analytics and then we go a step further. We show you high-level views of total block performance and drill down views at a granular level, stratifying risk to identify what each member is likely to cost the plan over the next 12 months . 

  • Gain insights of global risk factors within a population 

  • Identify historic patterns 

  • Stratify risk 

  • Identify high-cost drivers and accelerating conditions 

  • Define relationships at a granular level 

  • Define major diagnostic groups/codes 

  • Define pharmacy specialty drug costs