Risk Management Solutions
Analytics and decision support services provide clear measurement of your program's performance and return-on-investment to assess program impact and drive ongoing refinement for optimal results.
Advantage Suite® for Employers
Advantage Suite integrates information from diverse sources and systems, organizes it to support decision making, and enables easy access to information in a flexible, customized application. Its powerful applications are linked to an integrated warehouse of medical and prescription claims, encounters, eligibility, lab results, authorizations, health risks assessments, and performance measures.
Web-enabled Advantage Suite packages and organizes critical healthcare quality and cost information into views that compel effective decision-making. The solution provides a comprehensive measures catalog, and produces flexible and fast reports to maximize productivity and facilitate rapid information distribution.
Advantage Suite allows employers to perform in-depth analyses to answer the following questions:
- What are my most costly trends?
- How can I manage my health plan vendors to achieve the best program results for my employees?
- Does the employee out-of-pocket cost of my program affect the overall health of my employees?
- How can I identify the most appropriate health prevention and promotion initiatives for my employees?
Health & Productivity Management
Quantify lost productivity costs and establish programs to improve employee health and engagement with our health and productivity management solutions. We show clients how to better manage clinical and financial risk associated with an enrolled population's illness burden by:
- Identifying and addressing employee lifestyle and healthcare choices that negatively impact productivity
- Developing population-based disease management strategies to counter excessive spending on medical treatments, disability, workers' compensation, absenteeism, and lost opportunity costs
- Advising on plan and program design to target health and wellness improvement opportunities
- Estimating return-on-investment for existing programs with Value Realization Reporting.
Decision Support
Our professionals are recognized leaders in healthcare analytics and benchmarks, and use the MarketScan® Research Databases and the PULSE Survey to benchmark performance against demographic, industry, geographic, and other relevant norms. You can trust our analytics and decision support because they combine three respected healthcare information sources:
- Our analytic professionals - the best in the industry, spanning multiple disciplines
- The MarketScan databases - the most published source of private sector healthcare utilization and expenditures in the industry, with complete medical and outpatient drug claims for every covered life in the core databases.
- The PULSE Survey - the longest running privately funded telephone healthcare survey in the U.S., reaching 100,000 households each year and providing consumer data on more than 80 healthcare utilization and behavior topics.
Benefit Plan Design
Implement the best benefit plan design for your covered population with the help of our tools and solutions that model the effects of plan design on benefit quality, cost, satisfaction, and financial contribution levels for employees and the employer. In addition, you will:
- Discover reasons for enrollee plan switching, and develop incentives to stimulate use of generic drugs and higher quality providers
- Customize plan options for your covered population.
Performance Measures and Value-based Purchasing
Develop successful pay-for-performance (P4P) programs and value-based purchasing initiatives with the support of our expertise in performance measurement. Our step-by-step design and implementation process offers comprehensive solutions for organizations in all healthcare markets, from measurement selection and to data collection and integration methodologies, to building reward structures to gain buy-in and collaboration.
To ensure success for your P4P program, we help you by:
- Determining how to focus programs to achieve the best results
- Identifying the best nationally endorsed measures
- Evaluating program success and making necessary improvements along the way.
Data Management
We provide an array of data management and software services for public and private clients, with software tools that are intuitive, usability-tested, and integrated into your workflow, capable of generating customized reports for each end-user. Other data management services we offer include:
- Data quality analysis
- Data transformation services
- New linkages across data systems
- Custom software design for data validation, analytic computing, disease management, and Internet dissemination.
Advantage Suite - Employers
Advantage Suite® integrates information from diverse sources and systems, organizes it to support decision making, and enables easy access to information in a flexible, customized application. Its powerful applications are linked to an integrated warehouse of medical and prescription claims, encounters, eligibility, lab results, authorizations, health risks assessments, and performance measures.
Disease Management Analytics
Managing the acute and chronic conditions producing excess risk for employers is a complex challenge. As employers grapple with the reality of rising costs, they are studying the viability of disease management programs. To adequately evaluate disease management’s effectiveness, employers need:
- Information to determine employee health status and disease prevalence.
- Methods to determine which diseases, employees, and health programs will yield cost savings, reduced risk, and improved quality.
- Tools and criteria to evaluate return on investment of internal and outsourced programs based on projected cost savings and quality improvement expectations.
Health and Productivity Research
Empirical research, in partnership with Emory University, focused on the relationship between employee wellness, healthcare utilization and cost, and work-related productivity.
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