WHY CHOOSE HCRM

The Challenges Faced by Health Plans

In 2023, the average premium cost for employer-sponsored health insurance was $24,000 for family coverage, with the employer typically covering as much as 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.

Additionally, the sudden onset of weight loss drugs has impacted health plan costs dramatically and tracking obesity treatment compliance will be critical to derive value from these expensive medications.

HCRM predictive healthcare analytics uses 24 months of claims data and over 2800 health and cost measures to accurately identify members at risk of future health crises.

HOW OUR HEALTH PLAN ANALYTICS HELP

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 metrics of identifying risk, compliance with over 128 professional standards of care, and more. Clients can access our Health Risk Monitor system to clinically stratify a group, identify individuals for intervention, and create custom graphs, enabling outcome reporting for improved health and overall cost reductions.

Choosing between analytic vendors usually comes down to cost. Determine which vendor is worth the necessary cost and time needed to solve your organization’s problems and prevent future operational, cost-related, and clinical obstacles.  By focusing on the tangible benefits of healthcare data analytics and demonstrating how it can directly impact employee health and company costs, you can effectively market these solutions to employers and position your company as a valuable partner in optimizing their workforce health strategy.

Our Predictive Analytics for healthcare will help you improve member health and reduce overall costs in the following ways:

  • Accurate Predictions

    By utilizing the most advanced AI-driven Predictive Modeling and Forecasting available, HCRM can provide reliable data analysis for companies of all sizes. Our AI driven model is regarded as the most accurate claims-based prospective model available in the healthcare market, meaning you can trust the accuracy of our forecasts. Your business could be benefiting from the best that modern technology has to offer.

  • Measuring Risks in Dollars

    Risk analysis is only helpful if you can understand what it means. At HCRM, we recognize the need to quantify clinical and financial risks in dollars.  We take pride in translating clinical risk into understandable and comparable measures, giving you a direct way to measure and manage risk.

  • Staying Ahead of Rising Costs

    As healthcare costs continue to rise, understanding and addressing future clinical and financial risks is imperative. With HCRM services, employers can limit or avoid high-cost claims with actionable information. We help you accurately identify and understand the members and conditions that are driving your health plan costs so you can implement measures to close gaps in care, improve member health, track treatment compliance and avoid future claims.

KEY CONSIDERATIONS FOR CHOOSING HEALTHCARE ANALYTICS COMPANIES

Selecting a healthcare analytics company vendor is a complex process that requires careful consideration.

Whether considering an analytics vendor for the first time, or choosing to change existing vendors, the first step of the process is to reflect on your organization’s goals. Knowing exactly what you need to achieve within a specific time frame is the best way to narrow options. Determine why you need an analytics vendor and why now is the time to make a change. Is it cost-related? Improving the health and productivity of the workforce? The reasons should justify the research, time, and budget required for a change.

After identifying your goals, there are some additional considerations to work through to further narrow your options:

REPORTING

What reporting does your organization need for what uses? Do you require daily dashboard reporting for high-risk patients? What about cost efficiency metrics? These features are included in the HCRM system.  Determine your needs based on your predefined goals.

MAINTENANCE AND SECURITY

Choose a vendor that can keep up with changes in both technology and your needs. Does the vendor adhere to effective security and privacy policies? Will your analytics vendor be able to scale as your organization grows? Do they have sufficient security and privacy measures to protect your sensitive healthcare data? HCRM is SOC2, Type 2 accredited.

TRAINING AND CUSTOMER SUPPORT

How steep is the integration learning curve? Does your vendor offer the necessary training and customer support to get your team up and running quickly? Make sure your vendor offers timely, friendly and responsive onboarding and training.  HCRM has received numerous accolades in these areas.

EXPERIENCE AND EXPERTISE

Look for an analytics vendor with extensive experience and a proven track record of successful, timely implementations. The vendor should demonstrate their ability to accurately process data and fix problems with your data, such as home-grown and invalid diagnosis and treatment codes, etc.

CUSTOMIZED APPLICATIONS AND INTEGRATIONS

Ensure the vendor you select can integrate with your existing data sources cleanly, and efficiently handle the volume and complexity of your data set.  This is a key feature in the HCRM system.

DATA WAREHOUSING

Where will your data be stored? How accessible is it? HCRM stores all of its data in the US. How well will it be cleaned, validated and accurately processed? Depending on your organization’s needs, find a vendor that provides relevant information and not glitzy graphics or large data tables that are not actionable.