Balancing the complexity of maintaining competitive healthcare benefit offerings with controlling costs is a formidable challenge. To address this challenge, health plans need to evaluate the financial impact that proposed plan design changes will have on the organization and on enrollees’ out-of-pocket expenses.

To help customers quantify the cost impact of proposed benefits plan design changes, Thomson Reuters has developed a scenario planning tool — Benefit Design Modeler. Modeler can help you make accurate decisions quickly to more effectively impact your benefit management activities.

Benefits

Modeler can help you quantify the cost impact of proposed plan design changes by showing the effect of changes in overall plan design, co-pays, premiums, covered services, and benefit limits on costs to the organization and enrollee.

  • Provides an intuitive and easy-to-use Excel-based interface
  • Establishes a baseline that reflects industry group, enrollee demographics, and healthcare experience
  • Models the cost impact of plan design changes on costs for indemnity, HMO, PPO, POS, and consumer-driven health plan designs
  • Projects costs to compare to budgets to estimate variances
  • Improves ability to forecast expenses
  • Generates presentation-ready reports

The data in Modeler is populated with information from MarketScan® databases, proprietary market-leading benchmarking and research databases. Modeler uses actual claims cost and use experience, industry group, enrollee age/gender, and geographic distribution to tailor Modeler results to your healthcare experience. Optionally, you may choose to use your own data to populate Modeler’s assumptions.