Client Analytics

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Client Analytics Consulting
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• Rocky Henisey
• 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

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• 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 clients specific trends.

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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.
Collaboration Account Management Medical
Management Network Management Consultants/Brokers
Consultation Annual Plan Review Comprehensive
Utilization Analysis Recommendations Actionable
Insights Blue Care Connection Analysis
Client
Actuarial Services Trend Analysis Forecasting/Pred
ictive Modeling Risk Assessment Actuarial Studies
Research Analysis Project Based Reporting on
Key Diseases High Impact Claimants Population
Analytics Industry Segment Trend Analysis
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• What do Clients want?

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• Client Analytics

Actionable Insight ABCs Condition Comparisons
of Perinatal Conditions, Musculoskeletal, ESRD,
MH/SA and Pregnancy Complications have higher
PMPMs than the BCBSTXs Book of Business (PPO,
ASO 500).
Recommendations on Next Page Perinatal
Conditions Musculoskeletal ESRD MH/SA
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• 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

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• 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

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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

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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
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• 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?

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