You can’t manage what you don’t measure.

Everything we do for clients starts with detailed analysis of your plan’s performance against a backdrop of your management goals and market-wide trends. In addition to our Performance Scorecard, licensed best-in-class analytics tools provide us with actionable insights far beyond what’s available through standard reporting systems. On top of that, we compile additional data from focused plan audits, industry benchmarks, and our own market surveys.

It has always been our belief that timely and accurate data is critical to making informed decisions when managing a health plan. Many of our competitors simply rely on quarterly or annual data provided by the carriers to service their clients. We know there are often opportunities for additional savings by monitoring the plan’s performance more regularly throughout the year. That’s why we created our Performance Scorecard and invested in data warehouse and analytics tools, such as Innovu, to identify claim level management opportunities.

 

Monthly Scorecards

We produce our proprietary Performance Scorecard on a monthly basis and use it as a foundational tool to identify emerging plan trends, compare actual to budgeted plan costs, identify and stay abreast of unusual claims, and focus plan design and plan management efforts.

Available in a combined Medical & Rx version, as well as a new standalone Rx module, each month’s Scorecard includes key observations from your consulting team on the “measures that matter.” We think of it as twelve opportunities to assess how the plan is running and to make better and more timely decisions.

Learn more…

 

Benchmarking

As an independent firm, we are not restricted to using our own data. A wealth of information is now readily available in the marketplace ― much of it at no cost and some of which we pay for on a subscription basis.

In addition to creating our own benchmark data, we collect and curate benchmark data from international consulting firms, health plans, PBMs, specialty firms, foundations, industry professional organizations, and data warehouses such as Innovu. The key is how we match relevant resources to your needs ― something we’re pretty good at doing.

Our Annual Review & Planning Report enables clients to better understand how their primary plan design features and performance results compare to curated benchmarks. It also serves as a platform for discussing and pursuing future plan management ideas and actions, as well as keeping clients abreast of important compliance matters and deadlines.

Clients also have their own monthly Performance Scorecard to compare current costs to benchmarks throughout the year, as well as access to our own proprietary survey data (representing about 600,000 plan members in aggregate).

 

Claim Analysis

We have our own licensed claims data analysis and reporting software, and experience with other leading applications in the marketplace. That’s backed by decades of in-house expertise in this area developed through technical and leadership roles within major insurance companies and consulting firms. We also take advantage of direct access to health plan and PBM systems for ad hoc reporting and analysis. It is amazing what we find in our clients’ claims data!

CONTACT

Main Office
24651 Center Ridge Rd, Suite 110
Westlake, Ohio 44145

Phone: 440.892.2600
Fax: 440.892.8920
Email: info@chelkogroup.com

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