Quick insights help health plans stay competitive

Maintain your edge with our deep industry expertise and analytical strength

In an evolving and highly competitive marketplace, health plans are under intense pressure to improve performance and differentiate themselves. Successfully controlling costs, improving outcomes and expanding market share requires new, innovative tools and sophisticated analytics to help inform decision-making and guide the way.

HDMS provides health plans with a competitive advantage, enabling you to quickly access actionable insights and inform your decisions as you help clients mitigate financial risks and reduce medical costs.

18M

covered lives

800M+

records processed monthly

6,500

active users

 

Prioritize opportunities for new care management programs and identify candidates for interventions based on diagnoses, risk scores and gaps in care.

  • Identify high impact and outlier expenses
  • Evaluate your cost savings strategies and programs
  • Monitor results over time to achieve desired outcomes

Gain insights into the drivers of network leakage and opportunities to keep patients in-network.

  • Compare network providers to optimize your networks and contracts
  • Measure financial, clinical, marketing, sales, reputation, behavioral

Make decisions on plan performance and get key observations about an employer’s health care experience.

  • Build and evaluate alternative contract models
  • Assess outcomes related to new benefit designs and engagement programs 

Identify agents driving utilization and cost, such as:

  • Internal stakeholders: CMO/CFO/Chief Actuary/Sales/Contracting
  • Purchasers of health care: employer groups, unions, brokers, consultants
  • Regulators, government agencies, including Medicare and Medicaid
  • Members

See comprehensive views of data from multiple sources and pinpoint opportunities within targeted populations through unique reporting views.

  • Integrate data inputs from across the enterprise, including claims, financial, clinical, engagement programs, HR, demographics
  • Remain flexible for each client’s capabilities and needs

Leverage a flexible analytics infrastructure that scales, allowing many users to access integrated health care data for rapid querying.

  • See a comprehensive, flexible, high-value account reporting
  • Use an available white-labelled solution
  • Ensure consultative account management and support

  • Model clinical episodes of care over time
  • Measure, monitor and manage quality of care
  • Understand and respond to both retrospective and prospective risks
  • Compare performance to benchmarks

With the level of customization and detail the reports now provide, we have secured a competitive edge in the local marketplace. The new reports and deliverables have been very well-received by clients.


Blue Health Plan