Self-Funded Employers

Managing healthcare plans is a difficult task for employers. HCRM’s data analytics provide valuable insights into the financial risks and cost-saving opportunities of current healthcare plans. This data allows employers to make informed decisions about selecting programs and vendors to address risks effectively.

As a self-funded employer health plan, you bear the risk of increases in costs… but also benefit from savings. 84% of your claims costs are driven by 20% of your members – those with one or more chronic diseases. Additionally, those people, on average, receive only half the care recommended for their conditions and, therefore, are sicker than they should be and end up spending more money as a result.

Reporting Capabilities

  • The HRM online reporting system provides a wide range of metrics used to stratify your data, including demographics, medical conditions, gaps in care, etc., that can be generated at the cohort (Asthma, etc.) employer group and book of business levels.  These reports highlight costs and clinical trends as well as opportunities for risk and cost reduction in the future with drill-down to member level profiles.
  • HRM can also generate reports for any cohort in pdf format that highlight costs and clinical trends as well as opportunities for risk and cost reduction.  The reports can be white-labeled, customized, created on a monthly, quarterly or annual schedule and scheduled to be automatically emailed to clients, consultants or other parties as desired.
  • A Daily Dashboard alerting users to specific member claims for conditions (strokes, etc.) or events (inpatient admit, etc.) based on daily medical and pharmacy claims feeds is available for large case management, stop-loss reporting of potential shock-loss cases and health captive risk management.  The dashboard alerts are customized for each client.