Benefit From Our Data Experience and Expertise

Annual and quarterly consulting reports assist our clients to better manage their benefit plans, including trend drivers such as utilization, price, demographics, high cost claimants, and comparison to adjusted benchmarks. Benchmarks are derived from normative and other health benefits data that acts as a consultant to the client, detecting trends and opportunities to reduce cost and increase efficiencies.

• Analysis of health management opportunities leading to clinical conditions not being managed along evidence-based guidelines.
• Assessment of program impact through robust ad-hoc analysis and reporting capabilities from different perspectives, such as:
• Disease-based MDCs, DRGs, ETGs, etc.
• Cost of procedure, condition, diagnosis, type of service and facility
• Integration of data from multiple sources, including health risk appraisal, on-site clinics, care and diseases management program participation, medical and drug claims, etc.
• Targeted opportunities for improved communications with participants

• Assessment of vendor performance
• Identification of key issues and savings opportunities
• Ad hoc studies that investigate specific questions
  • Cost and utilization related to obesity
  • Utilization patterns of potentially addictive drugs
• Cost savings impact of an on-site medical center by plan, division and/or company code and demographic analyses

• Core reporting for budgeting and forecasting for benefit costs
• Potential plan design changes that could reduce costs without adversely impacting members or creating wrong incentives
• Projecting the impact of medical plan design changes, such as:
  • Impact of introducing Consumer Directed Health Plans or innovative plan design that encourages members to enroll in health and disease management initiatives
  • Potential cost savings and quality impact of migrating members to more efficient, high performance network of providers.
  • Impact of three-tier or formulary prescription drug design.

Data is integrated to review the relationship between these programs and the health care program, as well as the effects on medical claims trend, absence management and lost time productivity.