TULSA, Okla. – Employers offering health benefits face economic pressures like never before to identify and control costs and confirm their employees are getting the appropriate levels of care. They are asking vital questions, such as:

• What will we spend on diabetes, asthma and other chronic diseases next year?
• Which members of our health plan will utilize the most healthcare and have the highest costs?
• Do we know which members have gaps in their care and how can we help them?
• How do we know if we are getting a return on investment for our wellness and disease management programs?
• What actions can we take to control costs and help our members obtain the best care possible?

For nearly a decade, employers, Third Party Administrators, benefits brokers and others have utilized online Data Analytics technology from Benefit Informatics, a Benefitfocus company, to analyze, monitor and forecast health plan costs. With the introduction of Advanced Clinical functionality to Data Analysis and Reporting applications, Benefit Informatics customers can now assess plan risk, identify high risk and high cost individuals earlier and predict future medical costs. Advanced Clinical analysis provides integrated access to clinical predictive functionality on the existing Benefit Informatics online system. No additional data integration is required.

The Advanced Clinical functionality features clinical data analysis utilizing the Johns Hopkins Adjusted Clinical Groups® (ACG®) System, HEDIS measures and data elements supplied by the AHRQ (Agency for Healthcare Research and Quality). Combined, these clinical data analytics components give users access to comprehensive health risk and cost analysis in one integrated platform.

“We are very excited to offer our customers this new Advanced Clinical analysis functionality,” said Philip Kurtz, President of Benefit Informatics. “Our customers have counted on us for years to integrate multiple data sources, provide standard and ad-hoc reporting and help analyze various plan options. With Advanced Clinical functionality, we give our customers the ability to assess future risk and predict future costs for the plan and individuals.”

Utilizing Advanced Clinical analysis and reporting applications, Benefit Informatics customers can do the following:

• Identify high risk and high cost individuals early utilizing key diagnosis factors
• Identify members who would most benefit from case and disease management
• Identify “gaps in care” for key risk factors
• Forecast future medical utilization and costs based on risk stratification
• Evaluate effectiveness of health providers, wellness and disease management programs