1. Client Analytics & Consulting

2. 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

3. 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.

4. 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

5. What do Clients want?

6. 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

7. 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

8. 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

9. 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

10. 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

11. 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?