Everyone wants a high performing health plan, but how do you get there?
Data
W3’s skilled advisors utilize innovative analytical tools that guide employers toward effective data-driven employee benefits decisions. Data analytics play a crucial role in employee benefits because it enables organizations to make informed decisions based on reliable information. Understanding plan data is vital for organizations looking to create an effective and sustainable employee benefit program. With the right data you can continually monitor your plan performance, identify your claim drivers, and guide your members in finding the right care at the right time.
W3’s sophisticated Health Benefits Consulting Suite uses detailed financial metrics that include $300,000,000 in claims to:
- accurately assess the probability of success to move from a fully insured to a self-funded program using over 10,000 simulations
- quantify the impact that a proposed plan design change will have on claims
- simulate enrollment migration of proposed plan design or contribution changes
- project renewal rates well in advance of the carrier’s delivery
- calculate fully insured rate equivalents for a self-funded plan
- develop a sound contribution strategy
- benchmark your employee benefit plans against other companies of similar size, industry, and geography
Clinical Utilization
Optimal Clinical Utilization focuses on the appropriate and efficient use of healthcare services. It seeks to ensure that a patient always has access to high quality healthcare while being mindful of plan costs.
Optimal Clinical Utilization is not focused on denying services or putting up barriers to care. However, it is crucial for patients to understand that a physician’s recommendation about a medication, facility, or procedure is not the “only” viable course of action.
When done correctly, Optimal Clinical Utilization avoids healthcare waste, promotes preventive care, and encourages early intervention to avoid high-cost complex health conditions ultimately resulting in reduced plan costs.
Care Navigation
Care Navigation refers to the process of guiding patients through the complexities of the healthcare system to ensure they receive the appropriate care at the right time. It involves coordinating and managing a patient’s care across multiple healthcare providers, facilitating communication between providers and insurance plans, and helping ensure patients understand their diagnosis.
W3 assists clients with finding and implementing Clinical Care Navigation programs. Through our strategic partnerships, employers who engage with outsourced Care Navigation vendors find employees have better health outcomes and a stronger appreciation of their benefits program.