This book includes a plain text version that is designed for high accessibility. To use this version please follow this link.
Health Plan Interfacing

Re-inventing the healthcare broker business model

The need for new, cost-controlling technology is becoming even more imperative for healthcare brokers. By Keith Lemer


t’s no secret that America spends more on healthcare than any other country in the world, so new and innovative ways of

tackling escalating healthcare costs are generally welcomed with open arms. Particularly in the face of new health reform laws, the need for new, cost-controlling technology is

health reform laws, the need for new, cost-controlling technology is becoming even more imperative for

An Atlanta-based media company using HPM was able to address key risks identifi ed by the HPM analytics system by putting into place targeted wellness programs that ultimately resulted in a 79-percent engagement rate among the company’s members.

healthcare brokers who play a vital role in ushering in competitive health insurance options for their clients in an effort to stay one step ahead of their competitors who may be looking to take their business.

healthcare brokers who role in ushering in compe insurance options for th an effort to stay one st their competitors who m to take their business. Cloud-based

software-as-a-servi service-oriented hea ating system that leve

22 December 201122 December 2011 HEALTH MANAGEMENT TE

Cloud-based healthcare performance management (HPM), a technology-en- abled, data-driven strategy that helps organizations reduce healthcare costs and improve outcomes, is becoming an invaluable tool for brokers as it introduces a new methodology to the enterprise management of health plans and policies. echnically speaking, HPM is software-as-a-service (SaaS), a service-oriented healthcare oper- ating system that leverages health

performance m (HPM), a tech abled, data-dri that helps or reduce healt and improve o becoming an inv

for brokers as i a new methodo enterprise man health plans an Technically speak


plans’ HIPAA-compliant prescription data to predict a plan’s future costs and recommend risk-mitigating ac- tion plans. Analytics and predictive modeling, built around customized workfl ows and campaign tools, opti- mize the real-time trend analysis of a plan and give instant feedback on a plan’s success.

HPM technology provides brokers with the unique capability of using an organization’s prescription data to survey key workforce-population risk factors and trends and set into place preventive programs that work to stop high-cost claims before they are incurred. Effectively leveraging data to make smarter, cost-saving business decisions helps elevate the role of a healthcare broker to that of a trusted advisor, as real-time insight provides a previously unattainable level or

Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36