PlanIT’s proprietary tools and techniques allow us to link unique data from multiple carriers. This cohesive view of the total claim experience allows our clients cutting-edge visibility into underlying issues driving their claims.
With PlanIT bridging the gaps between claim types, nearly endless analytical opportunities become available to Employer groups. Below are common questions answered with integrated data:
- Are members with chronic conditions and/or negative biometric screenings having regular Wellness Visits? If not, where are they hitting the system? How expensive are these members?
- Do members with high ER utilization have access to primary care physicians? What factors might be driving their ER utilization? Location, plan design, conditions?
- How are our high cost claimants and high consumption members affecting our overall spend? Are they being effectively managed? Will they likely repeat this behavior next year?
- What plans and locations are the heaviest users in our group? How much are these employees paying? Is plan design effectively directing care?
- Are there opportunities to direct care to more efficient providers, possibly with bundled procedures? How are we being affected by out of network utilization?
- Are our chronic condition members, like those with Type II Diabetes, adherent with their prescriptions?
By analyzing all available data elements to look for integration opportunities, we have linked data for thousands of employer groups. Data types available for integration include:
- Onsite Medical & Pharmacy
- Workers’ Compensation