As healthcare costs continue to rise, companies need to know that they are getting the most out of their benefits investments. With our technology, your company’s health plan utilization data can be used to help you answer many important questions, such as:

• Why have Emergency Room visits increased in the last month?
• Which diagnoses are most common in our workers over the age of 45?
• How does our benefits plan compare to other companies in the industry?
• Which providers are we paying the most?
• How will our costs be affected if we change co-payment amounts?

Most companies struggle to manage data coming from multiple health plans, pharmacy benefits managers, third party administrators and other vendors, so they never fully understand where their healthcare dollars are being spent. We eliminate the administrative complexity typically required to collect and maintain this type of data by giving you access to utilization analytics that are easy to understand. By bringing together claims analysis, data warehousing, reporting, financial analysis, trending and forecasting, Benefit Informatics helps you truly understand and control healthcare costs.

Integrated Advanced Clinical functionality, featuring the Johns Hopkins Adjusted Clinical Groups (ACG) System, allows employers, payers and broker/consultants to assess risk and predict future plan and individual costs. Utilize Advanced Clinical functionality for 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