Client Analytics & Consulting

Rocky Henisey Darren Taylor Maureen Lowe Sally Marier Director, Client Analytics & Consulting – BCBS Texas (HCSC) Darren Taylor President, Cobalt Talon (Subsidiary of BCBS Kansas City) Recently VP, Enterprise Analytics & Data Management – BCBSKC Maureen Lowe Director, Client Reporting & Analytics – BCBS Tennessee Sally Marier Senior Director, Payer Solutions - MedeAnalytics Recently Director, Employer Reporting & Analytics – BCBS Minnesota

Client Analytics Client Consulting Overview – Providing Trusted Information and Actionable Insight. Medical Home – Answering client questions about ACO / PCMH growth and value. Prospect Analytics – Leveraging analytics to demonstrate differentiating value and win new business. Cost Savings Ideas – A few examples of creative solutions targeting the client’s specific trends.

Analytics for the Health Care Industry Analytics & Information Management provides Client Analytics services to assist clients with their important and difficult employee health benefit plan decisions. As an addition to the internal analysis, AIM also provides Client Consulting services which allow us to partner as benefit consultants with our clients helping them to identify their most valued opportunities, while addressing their critical healthcare challenges. Consultation Annual Plan Review Comprehensive Utilization Analysis Recommendations & Actionable Insights Blue Care Connection Analysis Collaboration Account Management Medical Management Network Management Consultants/Brokers Client Actuarial Services Trend Analysis Forecasting/Predictive Modeling Risk Assessment Actuarial Studies Research & Analysis Project Based Reporting on Key Diseases High Impact Claimants Population Analytics Industry & Segment Trend Analysis

What do Clients want?

Client Analytics Actionable Insight: Recommendations on Next Page: ABC’s Condition Comparisons of Perinatal Conditions, Musculoskeletal, ESRD, MH/SA and Pregnancy Complications have higher PMPM’s than the BCBSTX’s Book of Business (PPO, ASO 500+). Recommendations on Next Page: Perinatal Conditions Musculoskeletal ESRD MH/SA

Cost Savings Ideas Current Trends for demonstrating value to clients Population Health – integration of third party data (biometrics, HAS, Medical Registry, EMR) to fully assess member health and value of programs Predictive work: risk adjustments, extrapolation, statistical modeling, trending (rocky, can we tag team here a bit?) More details and drill downs: account structures, high claims analysis, code level analysis, procedure analysis BHI Usage / Large Benchmark datasets Account Histograms SIC Reporting Regression Analyses Client Specific Analysis – growing importance of adhoc support Example: ER Frequent Fliers

Pre-Sale Consultation What value does Pre-Sale Analytics bring to the account team and to the prospective client? Empowerment of the account management team Provides meaningful, actionable information to integrate into proposals and presentations Enables immediate collaboration capabilities with prospective client

Pre-Sale Consultation What information can you derive from a Pre-Sale Analysis? Core Pre-Sale Package Use of standard proposal data files Mapping based on diagnosis and procedure code Provides insight into appropriate program opportunities Enhanced Pre-Sale Package Allows for in-depth view of population health Provides insight into opportunities for optimizing decisions and management Enables projected impact based on prevalence and behaviors

Information Derived What information can you derive from a Pre-Sale Analysis, cont… Insight into Wellness and Preventive Care behaviors Targeting appropriate chronic conditions Opportunities for Optimizing Decisions Identification of Health Status and associated costs

What value does Pre-Sale Analytics bring to the account team and to the prospective client? What information can you derive from a Pre-Sale Analysis?