Intensive claims analysis extends beyond the highest-cost elements to include secondary reporting such as preventative screening, which can have even more predictive power than past claims.
For example, a secondary report would identify all the participants in a population who should be receiving preventative screenings–mammogram, colonoscopy, etc. That list is then cross-referenced with the actual number of screenings provided. These kinds of reports offer an opportunity to be proactive and use tools like population health, wellness programs and participant communication to reduce future claims and costs.
Intervention programs for chronic diseases such as high cholesterol, diabetes, hypertension, CAD, and arthritis are also designed to reduce costs that arise from deferred care.
Historical claims data that is analyzed using big data tools and algorithms helps generate predictions and cost-efficiency recommendations that are then synthesized with your company’s unique objectives, budget, and risk.
In this way, BHS delivers strategic benefit design that is more efficient, competitive, and that proactively promotes a healthy workforce.