Product List – Summary Overview
Data Analytics to document “Return on Investment” of Total Health Spend – WellScore data warehouse and business intelligence
Strength to Weight Ratio Screening Test – weight and muscle mass are accurate predictors of future health related issues in regard to employee jobs that have a physical requirement, such as nursing. Very strong positive ROI, in excess of 11:1, as documented by Cleveland Clinic.
GASB 43/45 Unfunded Liability Reduction Tool – use a Medicare/Retiree’s insurance products purchasing exchange to dramatically lower unfunded liabilities for Public Entities, oftentimes by 40% or more.
Rx Procurement and Performance Validation – third party contracting and auditing to ensure optimal performance and full delivery of PBM promised discounts and rebates.
Employer Driven National Rx Purchasing Consortium – national in scope, transparent and audited – average 10% to 25% documented cash savings.
Evidence Based Rx Formulary Management – clinical pharmacy management to assure efficient Rx purchasing – minimum ROI Guarantee 2:1.
Transparency Tool for All Size Employers – Concierge support for the covered people in finding clear pricing comparative data and claims questions support. Average employer ROI of 8:1.
Chronic Disease Quality and Cost Transparency – analytics program to support physicians and patients in identifying providers (physicians and hospitals) who render highest quality and lowest costs in treating over 200 chronic diseases. Very large potential savings to the self-funded employer, ACO or Health Plan.
Ambulatory Surgical Services Network – self-funded employers can save 6% to 10% of total health plan costs by utilizing an ambulatory surgery network.
Imaging Services Network – scanning services at substantially lower costs, saves approximately 2% of total health plan spend.
Evidence Based Medicine Employee Education Program – online Information Therapy focused on the medical condition affecting the covered person.
Medical Provider / Social Services Community Information Exchange – technology that connects the health care delivery system to the social services support system to maximize population health management. Reduces re-admissions and ED over utilization.
On-site, Near Site Clinics – national organization partners with hospitals to use direct payment primary care to enhance care access and lower costs for hospital employees and employers, while driving profitable revenue to the hospital.
Hospital Provider / Employer Direct Relationships – hospital branded business services to bring additional revenue to the hospital by offering services to the employers such as wellness, screenings, population health management, etc.
Medicare Plus Claims Pricing – technical support services for self-funded plans seeking data about difference between “discounted” provider payments and actual costs of care.
Population Health Management – full service wellness and risk management services including coaching, screenings, reporting. ROI guarantees.
Medical and Rx Claims Auditing – self-funded plans have a fiduciary duty to their covered members to protect the plan’s financial assets. Claims auditing should be done on a regular basis.
Dialysis Claims Pricing – self-funded plans are exposed to abusive pricing for dialysis services, using proper plan document provisions allows the employer to minimize the cost of care and protect the covered person from balance billing.