Benefit Design & Optimization

PROBLEM:

Employers and HR Benefit managers need to know:

the value of the premiums paid and the health care cost increase reasons what drives the changes in utilization and cost from prior periods how those changes compare to peer group experience what types of care their membership is receiving how comprehensive the provider network is and how good is the quality of care what is being done proactively to keep health care expenditures at acceptable levels how is the payer’s medical management program translating into productivity gains how efficient the plan is in paying the claims for its employees and dependents

Employers are struggling to understand hundreds of pages of reports and numbers provided by payers trying to justify the skyrocket health care costs. Visual Intelligence offers a comprehensive reporting platform to understand the drivers of the organization health care cost, quality andutilization issues. Visual Intelligence’s product EmployerHealthVIews is a holistic, innovative, and comprehensive solution that gets the insight and information benefit managers need to make better decisions, manage and reduce costs, optimize benefits, and much more including:

KPI/Dashboard presentation of critical metrics
Basic demographic analytics (gender, age, subscriber/dependent analytics)
Medical Cost and Medical Utilization analytics
Pharmaceutical Cost and Pharmaceutical Utilization analytics
High Impact Claims analytics
Geo-spatial Workforce Disease Prevalence analytics
Provider Network/Workforce Coverage Analytics
What If cost and benefit changes
Productivity analysis, LTD and STD claim impact from wellness programs
Extensive library of additional high value analytics and reports

OUR CAPABILITIES:

Executive summary level presenting cost, utilization, and quality metrics Data aggregating from internal and external sources and presenting it in an open book format Drill down and drill everywhere views of cost drivers from disease to utilization and quality Comprehensive financial projections for analysis of strategic opportunities. Drill down into the root cause of health care inflation and identifying members with emerging risk who have the potential of high cost Instant data filtering to identify top diagnosis, diseases, procedures, providers, and specialties by cost performance evaluation of disease management programs and other vendor programs Access the saving by conversion from insured to a self-insured arrangement and develop an integrated stop loss model. Detailed recommendation on benefits savings, projections, and benchmark targets (e.g. utilization rates per 1000, HEDIS comparisons). Determine how your employees compare to normative quality and cost statistics and analyzing monthly and quarterly trends against Identifying gaps in care

WHO CAN USE:

Benefit Managers, Directors of HR, Benefit Consultants, Analysts

PRODUCT SOLUTION