Value Delivered

By providing accurate healthcare data analysis, and by measuring Financial Management and Cost and Utilization (including medical loss ratio), BenefitsWatch gives finance executives, purchasing, benefits managers, internal auditors, risk managers and medical directors the information they need to manage health care costs and quality, and measure against expectations.

Compliance – all of this is delivered and interpreted by HDM in quarterly reports.

• BenefitsWatch results in monetary recoveries, procedural changes and benchmarks to provide a basis of understanding to negotiate more favorable agreements.
• Coding errors, overpayments, ineligible members and other fraudulent actions and plan issues are clearly identified, so savings and efficiencies can be realized at the end of the quarter being analyzed.
• Claims errors are connected to specific individuals and healthcare providers.
• Other party liability issues are detected, and resolutions recommended.
• Employers can meet their fiduciary responsibility in a corporate environment that increasingly demands more oversight.
• Public corporations, Taft-Hartley Unions and government entities are armed with actionable information to meet varied reporting requirements and public companies obtain the objective, third-party documentation needed to be in full compliance with Sarbanes-Oxley.
• BenefitsWatch establishes benchmarks that provide a clear path to contract changes that can lead to greater cost containment and ROI.

Financial Management and Cost and Utilization – these analytics also are delivered to clients quarterly, accompanied by recommendations.

This part of the BenefitsWatch process…

• Compares networks and plans to maximize discounts.
• Achieves best practice distribution of cost and incentives.
• Identifies provider, employee, dependent and Rx outliers.
• Isolates cost associated with Rx utilization outliers.
• Pinpoints unacceptable out-of-network utilization.
• Zeros in on chronic conditions that should be managed to contain cost.
• Identifies provider and member non-compliance with care management programs.
• BenefitsWatch generally provides an ROI of 4:1 or better. That’s for an organization or enterprise with 2,000 or more employees. For every 25 cents you invest with BenefitsWatch, HDM will return $1. Most important…savings are realized on a rolling quarter-by-quarter basis.

BenefitsWatch is budget-neutral. Cost per employee, per month comes from plan savings. Since it is also not a Web-delivered service – and no software is installed at a client’s Site – BenefitsWatch also requires no investment in staffing or technology. HDM does all the work.

To discuss how HDM’s cost containment solutions for self-insured employers can benefit your organization, contact HDM today at 800.859.5119 ext. 1 or e-mail your inquiry to: info@HDMinc.com.