Health Plan Analytics
Equip your healthcare organization with essential health plan data analytics.
The Challenges Faced by Health Plans
In 2023, the average premium for employer-sponsored health insurance was $24,000 for family coverage, with the employer typically covering three-fourths of this cost. This marks a nearly 50% increase in the average premium over the past ten years, and these costs are still rising. Chronic illness among members is the primary driver of these costs. Identifying these members for targeted intervention can help reduce costs, but it can be challenging as current costs do not always indicate future expenses and health events. For instance, an asthmatic member who is non-compliant with two or more standards of care is twice as likely to visit the ER as a member who is compliant with all measures. HCRM predictive healthcare analytics uses 24 months of claims data and over 3000 health and cost measures to identify members at risk of future health crises.
How HCRM Can Help?
At Health Cost & Risk Management (HCRM), we offer access to cutting-edge AI technology and group and member health analytics tailored to your specific needs so that you can better manage health plans, member health, and future costs. Our goal is to simplify the complex world of healthcare analytics for you.
Our Care Management software seamlessly integrates with the predictive modeling system to improve member engagement and monitor long-term health outcomes. This tool, combined with our team's training and support, is available both on-site and remotely. This valuable resource can be accessed whenever and wherever you need it. We can also help you generate customized reports and assist in interpreting the results of our prediction processing, providing valuable insights into population health analytics.
Breaking Down Our Health Plan Analytics
At HCRM, we empower health plan organizations with advanced data analytics previously limited to larger companies. These reports highlight data from your member base, detailing disease prevalence, yearly spending, future medical and pharmacy cost predictions, several ways of identifying risk, compliance with over 100 professional standards of care, and more. Clients can access our Health Risk Monitor system to clinically stratify a group, identify individuals for intervention, and then create custom graphs, enabling outcome reports for improved health and overall cost reductions.
The Benefits of HCRM Healthcare Data Analytics
It’s time to empower your organization with actionable insights for improved patient outcomes, lower claims costs, and long-term financial security. HCRM’s technology characterizes populations in terms of current and future health risks and costs, offering accurate data analytics to integrate vendors and providers. When you work with us, your organization will receive data pointing you in the right direction to mitigate health risks and financial losses.
Why Choose HCRM?
Accurate Predictions
HCRM’s Predictive Modeling, a healthcare industry leader, utilizes AI technology to create accurate forecasts of member clinical risks and costs. This allows the user to assess aggregate spending in the next 12 months and identify future high cost members and potential spec losses. HCRM’s analytics and forecasts permit health plans to formulate programs to address those issues now and avoid future claims.
Measuring Risks in Dollars
Your health plan performance is measured in dollars – are costs going up? How much and why? Those dollars are a function of each member’s clinical status and behavior. Translating those risks into dollars and related metrics gives you the ability to forecast future trends and plan programs to help manage member health and avoid costly events and their claims.
Staying Ahead of Rising Costs
Health plan costs continue to increase, often driven by uncontrolled chronic conditions and lifestyle choices. Focusing on last year’s high-cost members is not necessarily effective because they often spend less in the following year. HCRM predicts those likely to be high cost next year based on their current clinical condition, allowing you to take action and avoid or reduce the impact on future plan performance.
Streamline Your Health Plan Management with Healthcare Analytics
At HCRM, we aim to assist you with your work, regardless of your role. Our goal is to simplify member information analysis and provide you with accurate information to enhance your effectiveness. Our leading predictive analytics system is the most cost-effective system available and will streamline your daily, monthly, and annual processes while improving member health and reducing costs.
Schedule a Demo Today
Learn more about how HCRM can help you see positive health outcomes for your members while mitigating future risks.