Health plan data analytics

Health is connected, but data can be another story.

Get whole health insights with integrated data from across your enterprise and your partners.

Connected Health Insights

  • Build more value using enriched enterprise data
  • Bring in partner and point solution data
  • Present integrated reports to your customers
  • Fuel internal innovation and strategy


Unleash your analytic teams


Population Health

Analysis across many plans and partners.
Enriched data drives innovation.
  • What do members need?
  • What works best for who?
  • How are programs performing?
  • What should we do next?

Plan Sponsor Reporting

Share strategic value with plan sponsors.
Attract and retain business.
  • Show measured results
  • Tailor analytics to highlight value
  • Reveal opportunities for improved health and lower costs
  • Show optimization opportunities

Provider and network analysis

Optimize for your members.
Know your network.
  • Build Provider scorecards
  • Look beyond costs and consider SDoH
  • Easy access to data for negotiations
  • Proactive alerts for outliers

Financial Reporting

Get answers to busy executives,
even when the questions change.
  • Utilization and expense reporting
  • Extensive high cost claimant investigations
  • Dig into capitation analytics
  • Explore Premiums across plans

Big picture

Detailed insights

  • Enable fact-based consensus and strategic decisions
  • Measure and manage risk, act upon rising risk
  • Surface cost-saving opportunities
  • Evaluate performance to tune and optimize
  • Improve care quality and patient outcomes

Powerful analytics

Get more from data

  • Anticipate trends
  • Receive alerts
  • Watch leading indicators
  • Leverage predictions
  • Quantify the influence of social determinants of health

Use data differently and advance your strategic value.

 

Fast answers, at your fingertips

 

You have what they need

Your customers want the best for members too.

Let the flexibility and power of an analytic platform set you apart.

  • Visualize complex data so it’s easy to understand
  • Let them interact with dashboards and self-serve answers
  • Foster collaboration between brokers and clients
  • Use cutting edge analytics to adapt to rapidly changing needs
  • Send reports and alerts. Earn trust as a partner that brings transparency

Data is a pain.

Technology keeps changing. Partnerships change.
Questions are different.

With HDMS you have a flexible platform and people to work it so you can look forward – everyday.

Be a power user or give us your task list. Or both. Your choice.
We’re ready for you.

"We're able to provide [our clients] direct access to all of their data, and a way to view it as a story as opposed to just a series of reports."

– Shawn Shapiro,

Director of Client Analytics at Meritain Health

Health plan data analytics for a wide variety of markets

Challenges facing commercial plans

As a commercial health plan, you must maintain market competitiveness and optimize provider networks even as you navigate the transition to value-based care. That means figuring out how to improve members' outcomes, care quality and experience while driving down the total cost of care across varied populations. You need actionable insights.

How HDMS helps

Our experience working with commercial plans in a variety of distinct markets across the U.S. gives us an exceptional understanding of the data and insights you need to gain a competitive edge.

Case study

Discover how we helped one large Southeastern health plan determine utilization and medical costs for members participating in their health management programs.

Challenges facing federal plans

It's tough to keep pace with all the federal rules and regulations governing Medicare and Medicaid plans. In addition, plan managers face constant cost pressures to stay within state-allocated and enrollee budget limits while caring for highly complex member populations.

How HDMS helps

We offer Medicare and Medicaid plans opportunities for data-driven cost and quality control. Our sophisticated data analytics tools can help illuminate beneficial cost savings and quality improvement initiatives for even the most vulnerable and high-risk member populations.

Case study

South Country Health Alliance, a county-based health plan, turned to HDMS to leverage its large volumes of data to engage and improve outcomes for 41,000 members - all of whom are Medicare and Medicaid participants. With HDMS, the group's providers felt more comfortable taking upside and downside risk.

Challenges facing MCOs and regional plans

With fixed premiums, managed care organizations (MCOs) and regional plans take on more risk to ensure claims numbers hit the right targets. Knowing how to control member costs and design quality improvement programs is essential.

How HDMS helps

Our sophisticated data analytics tools have helped regional plans and MCOs measure and manage risk for years. We offer you the ability to identify the highest risk populations for more focused and effective cost and quality management programs.