Southeast Management Consulting

“We have to move from illness to wellness.  Businesses will have to invest in wellness.  There is no choice.  It’s not philanthropy.  It is enlightened self-interest.”   Shrinivas M. Shanbhag, Medical Adviser, Reliance Industries

 

In the U. S. alone, people with chronic disease account for more than 75% of the nation’s US $2 trillion in healthcare spending.

 

Globally, chronic diseases represent 57% of all deaths annually.  The World Health Organization (WHO) predicts that chronic diseases will account for approximately 65% of all deaths annually by 2030.

 

Productivity losses associated with workers and chronic disease are as much as 400% more than the cost of treating chronic disease.

 

Chronic disease is the prime cause of lost work time accounting for about 40% of total lost time.

 

Chronic Diseases are Largely Preventable,…. What Can Employers Do to Address Chronic Disease Prevention?

 

Understand the health risks of your employee population.  Tailor plan design benefits and wellness programs for your organization based on current healthcare needs.

 

Create a positive, proactive health environment in your organization.

 

Encourage usage of clinical preventative services by either covering those benefits in full or with minimal co-payment.

 

For those already suffering from chronic illness encourage adherence to treatment plans and medications developed by their physicians.

 

Communicate with employees about preventative services and benefit coverage.

 

Set measurable goals and objectives for increased individual responsibility for preventative screening and adherence to treatment plans required to achieve better health.

 

“Wellness and lifestyle improvement programs are rapidly becoming a top priority at many large employers, and with good reason.  Employers are recognizing that there is a direct link between healthy and engaged workers, high productivity, and controlling rising health costs.”  - Helen Darling, President, National Business Group on Health 

 

Do you understand the health risks of your employee population?

 

Learn more about NavigatorMD Design 180™ – revolutionary software that accomplishes the above critical tasks, through a single, easy-to-implement, affordable solution.  NavigatorMD Design 180™ is easy to learn / use and requires no additional employee resources or outside consultants.

Call 423-262-7930 or 423-343-5404;

Email navigatormd@semgmtconsulting.com for a free demonstration.

 

Introducing, NavigatorMD Design 180™ software,…the simplest, most comprehensive timely data source and analytical tool available for health plan design and management.

 

Use the analytical information to design your health plan and wellness program and measure the results/savings.

 

Chronic Disease Management (approximately 70% of total claims cost)

 

Indentify chronic conditions unique to your plan (over thirty predefined conditions) – % of population and claims cost

Immediate measurement of compliance with medical standards of care and cost related to compliance

Quickly/easily identify cost of increasing compliance

 

Preventive Screening / Immunizations

Identify compliance with medically recommended screens (i.e. breast cancer, colon cancer, cholesterol, etc.) based on medical guidelines

Identify immunization compliance

 

Plan Modeling / Design

Measure the impact of plan design changes on plan cost

      In/Out of Network Deductibles, Coinsurance, Out of Pocket Max

      Supports multi-tiered plans

      Assign specific coinsurance, deductibles, copays, occurrence limits,

      dollar limits to specific procedures / benefits

 

 

Cost Tracking / Data Analysis

 

Standard monthly predefined reports – plan summary, top ten procedures, top ten diagnoses, top ten providers etc.

Ad hoc analysis and reporting – drilldown capability and exportable to standard PC software

 

How it Works

 

NavigatorMD software is installed on a plan sponsors PC.  Your third party administrator (TPA) transmits raw claims data to NavigatorMD headquarters.  NavigatorMD maps your plans data, through its unique data transformation technology, to an encrypted database.  The information is fully HIPAA compliant and data display is controlled by software keys.  Historical claims data may be loaded at startup allowing immediate access to your plans baseline data.

 

When new data is available for your plan (at least monthly) with two clicks of your mouse you are downloading the data from NavigatorMD’s servers to your PC over the internet.  

 

If you can use an Excel spreadsheet you will have no problem using NavigatorMD

Phone:   423-343-5404    or   423-262-7930  

email: navigatormd@semgmtconsulting.com for a demonstration.

If your organization sponsored a self insured healthcare plan it is worth ten minutes of your time to read this letter.

I am a Financial / Management consultant with twenty years of experience “managing” self insured health care plans.  Managing is in quotes as plan sponsors have historically been ineffective in managing healthcare costs.  Healthcare is the largest “uncontrolled costs” most organizations face.  It is also a cost that both TPA’s and reinsurers have minimal incentive to control. 

The most valuable tool management has to run an organization is actionable information.  Organizations historically invest in sales reporting, inventory management/planning, product costing, and accounting analysis.  Typically sales information is available on at least a daily basis, with real time data becoming the norm.  Product costing information and financial results are typically available on a monthly basis with the emphasis being on quick turnaround of financial results so corrective action can be taken.

 

There is a lack of meaningful, timely, and actionable information for employer sponsored health plans.  Plan sponsors receive funding requests on a weekly basis from their TPA’s.  Typically TPA’s provide analytical reports either semi-annually or annually.  Plan sponsors are intimidated and challenged by the volume of information provided in these reports and rely on outside consultants / brokers to assist them with interpreting and analyzing the data.  TPA’s are constantly challenged by plan sponsors to reduce their costs and provide a high level of service to plan members.  The result is no one has invested in the information systems required to provide timely, meaningful, and actionable information for employer sponsored health plans.

 

NavigatorMD™, a software company headquartered in Knoxville, Tennessee, has developed a PC based product which bridges the information gap for employer sponsored self insured healthcare plans.  NavigatorMD™ produces standard “TPA style” reports from your plans claims data but does much more such as:

-      Over thirty pre-defined chronic conditions filters which will aggregate claims and demographic data (such as diabetes, hypertension, etc.)

-      Measurement of compliance with standards of care for chronic diagnosis’s and the cost for compliance versus non compliance

-      User defined Pivot reports

-      Drill Down capability on Pivot reports and views

-      Full plan modeling capability for use in plan redesign.  Deductibles, co pays, etc can be defined down to the benefit or procedure level.  Includes both a Heath Savings Account (HSA) and Health Reimbursement Account (HRA) calculator.  See the impact of proposed changes on plan data immediately

 

How it Works

 

NavigatorMD™ software is installed on a plan sponsors PC.  Your third party administrator (TPA) transmits raw claims data to NavigatorMD™ headquarters.  NavigatorMD™ maps your plans data, through its unique data transformation technology, to an encrypted database.  The information is fully HIPAA compliant and data display is controlled by software keys.

 

When new data is available for your plan (at least monthly) with two clicks of your mouse you are downloading the data from NavigatorMD’s servers to your PC over the internet.  The data is fully encrypted and is fully HIPAA compliant.  Persons designated as privacy officers by the plan sponsor are supplied a key which will allow personally identifiable information to be displayed on the privacy officers PC but it is stored on the PC in encrypted format.   

 

If you can use an Excel spreadsheet you will have no problem using NavigatorMD™

 

Whats the Cost

 

NavigatorMD™ software is licensed to the Plan Sponsor and the cost is dependent upon the length of the license term.  Minimum term is three years.  NavigatorMD™ also charges a minimal monthly fee per employee per month (PEPM) to cover the cost of supplying the data on a monthly basis.  The license covers up to five concurrent plan sponsor PC’s. 

 

The fees include ongoing support and training.

 

The return NavigatorMD™ will provide your organization far outweighs the cost.

  

This is a product that you cannot fully appreciate without seeing a demo.  Call   423-343-5404  or email navigatormd@semgmtconsulting.com to arrange a live demonstration.