Man pumped up about healthcare plan analytics


Doing more with data and analytics yields key insights

Data alone does not create sustainable benefits, rather, it is how the data is utilized to produce opportunity for value.

We have found that standard carrier reports do not allow for the granular view essential to mine actionable data. To provide you with a truly independent view we have invested in Verscend Population Health analytic software. Previously only available to mega-sized firms, this software allows RBA to analyze actual claims data to improve performance and reduce cost trends.

RBA’s Certified Actuary and Staff Medical Officer identify gaps in care and provide clinical analysis for stop-loss and high-cost claimants, as well as domestic network utilization and steerage recommendations.

Currently, our agency has over 30,000 lives with over 200,000 life years of data from employers throughout New York and receives direct feeds from TPAs and most major carriers across the state, including Empire BlueCross BlueShield. This data has enabled Relph Benefit Advisors to:

  • Reduce several client’s medical loss ratio from a range of 100-120% to a consistent 80-90%.
  • Demonstrate to a Carrier that we should file a separate, exclusive plan with the state, to offer to our Not-for-Profit Clients.
  • Consistently outperform the insurance carrier’s book of business.

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Actuarial and Data Analytic Services

Rate Development, Reserve Analysis and Reporting (Self-Funding)
Medical and Rx-relative Plan-value Modeling
Clinical Utilization Analysis, Including Benchmarks
Gaps-in-Care Analysis
Migration Predictive Modeling
Disease Prevalence and Benchmarking
Carrier Renewal Review
Risk-tolerance Analysis

Make better healthcare decisions using data analytics

Meet Ellen our Director of Clinical Review and Sharon our Chief Actuary. Using Verscend Population Health Analytics solutions Ellen looks for ways to identify and prevent future health issues as well as how to get the best care for the money. Sharon identifies financial opportunity and risk to assist with plan design and pricing renewals.

Do more with your data.