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There are 10 item(s) tagged with the keyword "TPA".

Displaying: 1 - 10 of 10

S&S HealthCare Strategies, Ltd. Selects Advanced Plan for Health as Predictive Analytics Solution Provider

WESTLAKE, Texas and CINCINNATI, Ohio, July 18, 2018 Advanced Plan for Health (APH), a provider of advanced and predictive data analytics technology today announced that S&S HealthCare Strategies, Ltd., a well-respected and innovative Third-Party Claims Administrator has added APH’s Poindexter analytics to their solution portfolio.

Tags: S&S HealthCare Strategies, Third Party Claims Administrator, TPA, Advanced Plan for Health, Predictive Analytics, Poindexter
What more do employer groups expect from their health plan or TPA?

In this busy selling season for TPAs and health plans, we wanted to share an updated eBook that outlines some of what the Advanced Plan for Health is hearing from our TPA, health plan and employer clients related to what employers are really looking for as they’re shopping for benefits.

Here’s an excerpt:

Providing your employer clients with the right mix of services and support boosts your chances of standing out and winning and retaining their business. Fortunately, most self-insured employers want the same thing: healthy employees, positive employee healthcare experiences and reduced costs. Sounds simple enough, but how can you be sure that you are offering the best solutions in today’s strained and ever-changing healthcare environment so that you can continue to differentiate yourself and show value?

Tags: Health Plan, TPA, Third Party Administrators, Employers, eBook, Advanced Plan for Health, Employee Benefits, Employee Benefits
Combating Opioid Addiction with Analytics and Case Management

The current opioid epidemic has shed light on the shortcomings of many wellness programs and the lack of preparedness by case management teams to handle chronic conditions and or patient behavior, such as addictive tendencies or duplicate therapy. But are case management teams solely to blame for lack of effective response to this costly health crisis? The simple answer is, no.

Many case managers do not have access to the data or tools required to employ a compelling and value-driven prevention model. Hence, what we see today is very little accountability or effective case management. What’s needed most is quality data to guide active engagement with patients.

Tags: Opioid, Addiction, Data, Big Data, Predictive Analytics, Account Management, Health Plan, Insurers, Healthcare, Brokers, Payers, Third Party Administrators, TPA, Epidemic, Case Management, Care Management, Care Manager, Wellness Program, Group Benefits, High Cost Claimants, Costs, Chronic Conditions, Behavior, Duplicate Therapy, Rx, Patients, Advanced Plan for Health, Actionable Insight, Health Intelligence, Poindexter, Self-Insured, Health Plan Sponsors, Catastrophic Medical Events, Drug Costs, ER Utilization
Prospecting, Networking and Lead-Gen at 2017 Hottest Shows: Employee Benefit News (EBN), America's Health Insurance Plans (AHIP) and International Foundation of Employee Benefit Plans (IFEBP)

Every year a vast selection of healthcare conferences, expos and tradeshows are carried out throughout the country. Undeniably, some of these shows provide greater target-rich environments for prospect8ng and lead-gen, opportunities to showcase or advertise your product, and to establish your company or brand as a leader in the industry. Let’s look at some of the top shows for Population Health, Health Benefits, and Health Plans for 2017.

Tags: Healthcare, Conferences, Expos, Tradeshows, Population Health, Health Benefits, Health Plans, Demographics, Attendees, EBN, Employee Benefits Network, Brokers, TPA, Benefit Analysts, Benefit Service Providers, Senior Executives, America's Health Insurance Plans, Taft Hartley, Coalition Leaders, Fund Administrators
Advanced Plan for Health Upgrades Next-Generation Predictive Analytics On Poindexter Population Health Management Platform

Poindexter’s newest release pushes the boundaries of predictive modeling by determining the likelihood of an occurrence of coronary events, neurological events, orthopedic events and chronic kidney disease. In addition, Poindexter now has the ability to predict hospital length of stay and general likelihood of an ER visit for any member of a patient population.  

Third-party Administrators (TPAs) and brokers can leverage Poindexter’s new functionality to better identify at-risk individuals in their customers’ insured population. Employers with self-funded health plans can directly benefit, too.

Tags: Predictive Modeling, Population Health Management, Self-Insured, Employers, Health, Data Science, Actionable Data, Coronary Events, Neurological Events, Third Party Administrators, TPA, Health Insurance Brokers
Chris Galanos - Director, Medical Services

Chris Galanos was Vice President Customer Solutions–Care Management for UMR, the third-party administrator (TPA) unit of UnitedHealthcare. He was responsible for the UMR portfolio of care   management services.

Tags: Bachelors, History, English, Texas Tech University, Harvard University, Harvard School of Public Health, Health, Customer Solutions, Care Management, UMR, Third Party Administrators, TPA, United Healthcare, Management, Sales, Medical Management, Strategic Planning, Product Development
Joy McGee-Cory - President CEBG/Senior Vice President Advanced Plan for Health

Joy McGee-Cory advises health systems, managed care organizations, integrated delivery systems, and physician groups on managed care operations, provider compensation and contracting, regulatory compliance, and accreditation issues.

Tags: Health Systems, Managed Care Organizations, Integrated Delivery Systems, Physician Groups, Managed Care, Provider Compensation, Contracting, Regulatory Compliance, Accreditation, Analysis, Proposal Development, Employer-Sponsored, Health Plan, Provider Network, TPA, Third Party Administrators, Medical, Management, Data, Firms, Policies, Procedures, Utilization Review Agent, URA, Medical Review Organization Certification, National Committee for Quality Assurance, Assessment, NCQA, Policy, Procedure, Payor, Reimbursement, Analysis, CEO, Members, CHIP, Participants, Market, COO, IPA, Capitated, Senior-Vice President, Medical Education, Hospital-Physician, Medical Group, Masters, Business Administration, University of Arkansas, Certified Physician Management Executive, Certified Purchasing Manager, Medical Group Management Association, Texas Association of Preferred Provider Organizations, TAPPO, Nonprofit Health Corporations
Health Plans

Every health plan and TPA should aim to provide data and actionable insights on how healthcare is currently utilized in order to help clients best manage costs, quality and delivery of care.

APH partners with health plans and third-party administrators in a variety of ways. We attentively support your efforts to manage population health, medical costs, assess/mitigate risk, improve/measure care quality and delivery, and identify future cost drivers/trends through member and provider specific data analysis.

Tags: Health Plan, Population Health, Data, Healthcare, Manage, Costs, Third-Party Administrators, TPA, Medical Costs, Mitigate Risk, Care Quality and Delivery, Future Costs, Identify, Cost Drivers, Data Analysis, Data Mining, Easy To Use, Customized, Cost-Saving
Employers

Containing health benefit costs and improving employee performance are top five concerns for CEOs and CFOs because of the direct relationship with the bottom line.

Tags: Costs, Employee, Healthcare Costs, Self-Insured, Health Insurance, Benefit Program, Brokers, Providers, TPA, Manage Risk, Data, Solution Modeling, Reliable Insights, Cost-Saving
Markets

We work together with clients and their partners to provide the visibility they need to manage health risk and cost. Our expertise complements the information you currently have at hand to give you and your team a clearer view and practical action plans.

Tags: Population Health, Healthcare, Risk, Reduce Medical Spend, Health, individual health status, Employers, Brokers, Providers, ACO, Health Plans, Consultants, TPA, Health Insurance, Big Data, Data Science, Solution, Modeling, Cost-Saving, Self-Funded, Technology, Predictive Analytics

Displaying: 1 - 10 of 10