Analytics and Underwriting
Proactivity is power, which is why we’ll keep you informed about the trends and risk factors that drive healthcare costs upward and drill down on utilization patterns impacting your bottom line. Equipped with a deep understanding of medical claims data, a strong acumen for actuarial modeling, and industry leading analytics platforms, our team empowers you to take control over your benefits spend. You’ll gain actionable insights about how your health plan is currently performing and which factors may affect future outcomes, so you forge your best path forward.
ANALYTICS & UNDERWRITING SUPPORT
Powered by technology
Our team of experienced underwriters and actuaries leverage innovative tools and technology to effectively analyze the cost of your
programs.
Examples include:
Healthcare analytics platform
Our data warehouse includes a powerful healthcare analytics platform that allows us to analyze the cost, care quality, and population risk factors for different employee groups. After interpreting the data, we’ll have a clear understanding of how to best manage your healthcare program to positively impact future plan spend.
Predictive actuarial software
Using our advanced actuarial software, that is populated with more than 10 million lives and more than $100 billion in claims, our underwriters can determine the implications of benefit plan options and forecast the pricing of plan changes and employee plan migrations for your company with a high degree of accuracy.
COMPREHENSIVE REPORTING
Instilling confidence for the future
Claims data is a powerful resource. When we have access to claims data for your health plan, we can produce comprehensive reports that review your plan experience, forecast how that data and experience translates into future premium impacts, and present viable options to help manage and prevent future claims.
Regular periodic reporting
We’ll deliver consistent reports that provide clear and direct insight into your health plan’s performance, such as:
- How employees are utilizing care options, like emergency care
- How much you’ve paid out, either in premium or fixed costs
- How much was spent on claims and prescriptions
- How many large claims occurred over the reporting period
- Which factors are driving large claims and the likelihood of recurrence
- What prescription drugs were ordered and how much they cost
- What the top diagnoses were during the period
- How chronic conditions and disease management are affecting cost
- And more
Renewal projections
Proactivity positions your organization for success. Well in advance of your renewal, we’ll analyze your data, run predictive models that can help estimate your cost increase, and find ways to mitigate the impact – putting us in a better position to negotiate on your behalf. Our team will:
- Align the population into risk categories to see if/how chronic health conditions are a factor
- Forecast issues and behaviors that may drive up costs
- Estimate future large claims and their impact on overall plan results – since large claims are the main driver of how well your plan performs
- Analyze utilization to see where potential challenges may exist and develop communication strategies to change behaviors and mitigate cost
- Identify care gaps early through quality metrics
Benchmarking
We’ll help you keep your health plan competitive by identifying where it stands in comparison to peers in your industry, geographic region, and with similar demographics. Our team will:
- Look at your industry and the number of your employees
- Analyze demographics, geographic locations, and utilization trends
- Compare plan designs and premiums side-by-side for medical and other health-related benefits
- Provide recommendations about how much you should pay to provide health benefits
- Present viable plan design options and cost sharing structures
Recommendations/Cost of Options
Utilizing our underwriting expertise, reporting capabilities, and leading technology, we’ll work together to provide recommendations about the health plan that will help you manage your program and ensure it’s competitive and cost appropriate. You’ll get the insights you need to make informed decisions, including:
- Cost of renewal projection based on your plan design, demographics, and claims
- Analysis of renewal pricing from insurance companies
- Estimated costs of specific plan design changes
- Evaluation of cost and financial risk for moving to a new funding model option
- Estimated enrollment migration using plan design and contribution changes
THE BALDWIN GROUP INSIGHTS
Stay in the know
Our experts monitor the employee benefits space and compliance updates to provide meaningful insights and help break down what you need to know, potential impacts, and how you should respond.
Open the door to the possibilities ahead
When you decide to partner with us, you choose to deliver on your promises and commitment to your employees with solutions as distinctive as they are.