We invest heavily in developing ready-to-deploy proprietary tools, databases, and methods.
County-level profitability assessment: Our actuarial analytics use CMS benchmarks, competitor-performance metrics, and local disease burdens to determine the ability to achieve success with specific products at the county level.
Medicare Growth Model: We use a proprietary advanced-analytics model to predict growth of Medicare Advantage, Medicare Supplement, Medicare Part D, and traditional fee-for-service programs at the county level.
Member Lifetime Value Model: We use a tool that calculates the lifetime value of an existing or potential Medicare Advantage member using claims data, demographic data, and risk-coding history, to help in the implementation of specific interventions to improve retention and attraction rates.
Lead-scoring analytics: Our comprehensive suite of predictive analytics, including likelihood to buy, likelihood to churn, and likelihood to convert, scores leads based on conversion opportunity.
Best-fit product matching: We use advanced analytics to determine a member’s optimal Medicare product based on various inputs including past utilization, third party consumer data, and past interactions, to optimize member experience and satisfaction with their coverage, hence improving conversion and retention.
Telesales-agent-optimization tool: Our interactive platform provides agents with a best-fit product match and customized member-level value propositions, interaction history, and utilization insights to enable a positive and seamless sales experience for members.
Risk adjustment: Our proprietary advanced-analytics suite identifies gaps in coding and evaluates performance by line of business, market, vendor, and provider. This comprehensive performance teardown, along with our proprietary database of industry benchmarks for supplemental-program performance, enables us to assess the opportunity at a granular level to improve intervention-strategy design for clients.
Stars Performance Diagnostic: We use a comprehensive diagnostic tool to prioritize metrics and identify the highest ROI interventions to achieve high quality ratings across member experience and clinical outcomes measures. By achieving and retaining 4-star ratings and higher, payers are able to offer more competitive products to meet member needs.