Cost continues to be one of the biggest concerns & one of the key objectives for a self-funded employer group is to get visibility or control over the cost & utilization. However, employer groups wait on answers from the health plan on two key questions
- What value is the employer group and its employees getting for our premiums, and
- What’s driving our cost increases year to year?
Infosys Payer B2B platform provides for contextual AI driven next best action & recommendations around buckets that are driving up costs along with contextual recommendations around patient deflection to low cost options, possible member interventions and concierge services.
Key Challenges
- No visibility or control over the cost & utilization
- Difficulty in identifying opportunities to bring down overall medical & drug spend for the plan sponsor population
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The Solution
Cost and Utilization Transparency
- Real time comparisons across dimensions
Infosys Payer B2B platform provides cost and utilization comparisons across a timeline on Place of Service [POS], top chronic conditions and top ICD / HCPCS / CPT codes. - Real time recommendations
Infosys Payer B2B platform provides contextual AI-powered recommendations for identified opportunities to bring down overall medical & drug spend for the plan sponsor population. - Integration with Health Concierge
Infosys Payer B2B platform provides opportunities for targeted near real time interventions by identifying members who are in high-risk category for hospital re-admissions and / or ER re-visits and routes them through the Health Concierge on the Infosys HELIX platform.
Real time recommendations
- Provide AI-powered next best action & recommendations on bringing down medical & drug spend
Benefits
Self- funded employer group to get visibility or control over cost & utilization
AI driven actions and recommendation to reduce cost.
Recommended low cost options, member interventions and integration with concierge services to patients.
