Decision Master ® Warehouse A New Dimension in Claims Analysis.

Post on 26-Dec-2015

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Transcript of Decision Master ® Warehouse A New Dimension in Claims Analysis.

Decision Master® WarehouseA New Dimension in Claims Analysis

What is Decision Master Warehouse?

• Decision Master Warehouse (DMW) is a state-of-the-art, analytical health claims decision support system that lets Commercial Insurance help you:

• Illuminate potential cost or utilization problems

• Isolate the underlying causes of those problems

• Determine money saving solutions aligned with your business goals!

How Can Commercial Insurance uses DMW to Manage Your Health Plan?

• Benchmark your health plan data against national norms of similar employers using Medstat’s Marketscan dataset

• Uncover the root causes of rising medical costs• Offer plan design modeling tools, or “what if”

analyses that help you determine the effectiveness and magnitude of plan design changes

• Provide complex information in an easy-to-use and easy-to-understand manner

• Help you make better decisions faster!

DMW Home Page

• Discussion Points

• Management Report

• Drill-Down

• Alternative Modeling

The DMW homepage is where the analysis begins.

Notice the menu options across the toolbar:

Better Brokers, Incorporated

Discussion Points

The Discussion Points section highlights key areas where the plan varies from the norms and contains recommendations for each area.

Management Report

The Management Reports section produces a custom executive summary that can summarize data in over 70 different exhibits!

Advanced Management Reports

Building a customized Management Report is as easy as clicking on the exhibit pages you would like to include!

Management Report Exhibits

• Total Health Plan Costs • Claims by Age• Claims by Relationship• Claims by Network/PPO

Affiliation• Inpatient and Outpatient

Claims• Claims by Place of Service• High Cost Claimants• Claimant Distribution • Top Hospitals• Top Doctors and Clinics• Inpatient Hospital Usage and

Cost • Inpatient Days/1000 and

Payment/Day• Maternity Usage and Cost

• Top Inpatient Surgery Procedures

• Top Outpatient Surgery Procedures

• Emergency Room Utilization and Cost

• Office Visit Utilization and Cost• Chiropractic Utilization and

Cost• Inpatient Mental Health

Utilization and Cost• Outpatient Mental Health

Utilization and Cost• Claims by Major Diagnostic

Categories• Lifestyle-Related Claims• Disease Management and

Intervention Opportunities• And many more!

Management Report Norms

• Compares your health plan costs and utilization to normative data

• Utilizes Medstat’s Marketscan database which includes over 5 million lives

• Norms are adjusted by age, gender, region, and industry to match your population

• Identifies cost or utilization concerns for your plan

Drill-Down

Drill-Down is organized into major categories, or cubes, such as Inpatient Hospital, Office Visits and Outpatient Mental Health. These cubes allow you to locate the root causes of your cost or utilization concerns.

Drill-Down

Each cube contains a number of pre-built drill-down exhibits that are just one click away!

If the pre-built exhibits do not suit your needs, not to worry! You can create advanced cubes that let you choose which data elements, or categories, you want to drill into.

Drill-Down

The Drill-Down screen features drag-and-drop report building. It’s the easiest custom report writer available to get at your detailed claims information.

And, charts can be created on the fly, exported into Excel, or saved offline!

Alternative Modeling

The Alternative Modeling screen shows your current plan design along with any number of alternative designs to compare it against. This provides both the plan savings and the members affected, addressing both the financial and HR impact.

Alternative Modeling

Any combination of over 84 input variables can be used to model your plan everything from calendar year deductibles and coinsurance, to office visit copays and maximum ER visits!

Alternative Modeling

The comparison screen shows how your current plan design stacks up against your alternative plan. DMW displays both the financial impact and the HR impact. How much money will be saved? How many members will be affected? DMW lets you know!

Questions

Any questions?