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.