Meritain Health® - In the Booth

TCOC: Actionable Data

February 22, 2021 Meritain Health Season 2 Episode 5
Meritain Health® - In the Booth
TCOC: Actionable Data
Show Notes Transcript

The value that Meritain Health provides through Actionable Data.

Expertly reviewing your plan will help you maximize your utilization, for the most value and efficiency. We’ll use our data analysis tools to give you: 

  • Information and decision support. 
  • Integrated health care data across multiple platforms. 
  • Better patient outcomes. 
  • Improved financial performance. 
  • Quality and efficiency metrics. 
  • Industry benchmarks. 

Welcome. My name is Bridgette Cassety, I am in the broker engagement department here at Meritain health. I am pleased to be joined today by Dave Parker, who is our head of sales for national accounts here at Meritain and Dana Roy who manages our informatics department. Today we are going to be talking about the value that Meritain provides through actionable data. Which is one of the core components of our total cost of care approach.  I am super excited to have Dave and Dana here with me today to talk about this and look forward to our discussion. So, Dave, I thought I’d look to you first to kick off our conversation and just give us some perspective that when you think about actionable data, what does it mean to you?


Thanks, Bridgettete, actionable data is a broad stroke of things.  Focusing mostly on what we can do with the information that we provide. Our clients want answers. They want to understand their expenses. They want feedback and input from us, or brokers and consultants want that as well. They want to make intelligent decisions and we need to give them that type of data to take action to it.


I think a key thing that you said there, Dave is intelligent data. Dana when you think about intelligent data and what we have available here at Meritain, can you talk a little bit about some of the analytical tools and resources that our brokers and clients have access to in order to accomplish that? 


Absolutely. We provide our clients and brokers with direct access to our Atlas analytics tool. This is actually one and the same tool that our healthcare informatics department utilizes to complete analysis for our clients and brokers.  Accessing Atlas provides direct access to your data when it is convenient for you.   It also allows you to modify reports to meet your needs if desired. Of course, we have a standard set of reports that our informatics department created for brokers and clients as well. Additional transactional reports like our transaction package, discount, evaluation, and lag reporting are available via our portal as well. When it comes to making decisions, it is all about actionable data with context. In Atlas, we offer things like benchmark reporting to help add context, which can be especially helpful when adding context for our newer clients. For those clients that have been with us for some time they can analyze year over year trends up to three years’ worth of rolling data. With Atlas, you can really stay as high level or dive as deep as you want to claim the data, going down to things like diagnosis and procedure code level, if desired. In addition to being able to access their own data and monitor trends, financials, and utilization, we also have an informatics departments that can assist with building reports and provides the overall Atlas support. Informatics also works closely with our client management account owners when analyzing their client's data to provide database recommendations specific to meet our client's needs.


When you talk about Atlas, Dana, there is certainly a lot packed in there. It's certainly a comprehensive approach that all of our clients and brokers have access to. Could you talk a little bit more about how customers can use Atlas to make informed decisions? 


Absolutely. When trying to determine what is in the pipeline from a financial perspective, we have several solutions available. We have a lag report that's provided monthly. It is essentially a triangle report that provides paid amounts, by incurred and paid months. This reporting generates a lag factor that measures the average amount of time from the incurred date of a claim to the paid date. Allowing insight into potentially incurred, but not yet received claims. In addition, we also have the ability to review claims trends by service category, diagnostic categories, and much more. Observing these trends over time allows for forecasting on hot diagnostic categories, for example. This is also where planning recommendations come into play when trying to mitigate any negative trends from continuing. Then a third solution around risk scoring. In Atlas we have the ability to risk score your population, including various adjustments for things like age and gender.


Dana when you talk, certainly data is a big part of our world in healthcare, and there is so many things that you can do with it. I think one of the strongest statements you made is that data without context is just data. So providing that context is really important when we're talking about forecasting and looking at recommendations. Dave, certainly Dana talked a lot about how our external customers utilize the data in a lot of ways, but I thought it might be helpful for you to talk a little bit about how we use data here at Meritain and how we use that to drive a better member experience.


Absolutely Bridgette, several years ago, our ops team created an additional division, a member experience advocacy team that takes data and really creates internal actionable steps with it. It's a proactive team that is focusing on escalated issues could be out of network type claims, could be experimental type treatments things that we'll get alerts on and they will work with the members to help try to resolve. it is a much different experience than most any other payer provides and is an outstanding solution for our members and clients.


when I think about all the things that you and Dana have talked about today, I guess the last question I'd have for both of you is when you look at the healthcare landscape in our industry, and we think about actual data and total cost of care, what is the unique value proposition that Meritain has? What's the number one advantage? Dana, what would you say to that? 


Having direct access to data and the ability to create customized reports at your fingertips, as well as having the resources to help you understand your data story is powerful, but data is really just data without numbers or without context, I should say. Once context is added, it becomes actionable. And that's where Atlas and our partnership across departments at Meritain as well as our partnerships with our clients and brokers is so important. Our goal is to help our clients and brokers understand their trends and total cost of care, driving discussions, and ultimately informed decisions about their plan design.


Dave, what would you add to that?


Ditto would be the best, but I would really just pile on that, that, from our perspective, our clients own their data and we want to make absolutely certain that they have it again, they can make intelligible decisions with it, they can take action with it. Its imperative from our perspective that we provide them with a great depth of resource, the team that provides us as well as the data that they need.


 In closing and in summary of our discussion here today, when we think about total cost of care and actionable data, being a pillar of that responsibility, certainly we have the resources and the tools available. We have the intelligent data that could be actionable that you guys all talked about. And that really how you take that for forecasting and making informed decisions is a real opportunity that we have here at Meritain because like you said Dave, the data belongs to our customer all we want to do is help them utilize that, to make the best decisions that they can for their employees. So I want to thank you both for taking some time and joining me today and to our listeners. I hope that will join us for another segment on total cost of care with Meritain. Thank you.