Data Mining

Your ability to manage your plan costs can be compromised if you don’t have access to actionable data.  If you are self-funded with more than 500 employees and rely on standard carrier reporting to make decisions, you are restricted in your ability to really understand what is going on inside the plan. Our experts use physician-created software to perform a corporate health plan assessment in which they audit your plan, identify cost trends and drivers, and offer risk management strategies for success.

  • Proprietary 10-step health plan audit which evaluates pharmacy, duplicate claims, hospital CPS, MRI and DME, among others
  • Predictive risk modeling of members to give you advanced health care planning
  • Evidence based care-gap compliance and provider accountability
  • Unit cost control to protect your profit margins
  • Cost-effective solutions for chronic disease management, cancer care, and dialysis
  • Strategies for prescription drug therapy compliance and generic drug use
  • Wellness initiatives to keep employees healthy and productive

When you get better data to work with, you will begin to see areas of your plan performance you never knew existed. We will assist you every step of the way in understanding what is happening “inside the numbers” to create real cost containment in your group medical plan.

Sample Data Mining Report
(Click to enlarge image)

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