Major & Regional Medical Carriers

Carriers manage risk in a highly competitive space. BST helps carriers improve network design and align products to their client’s risk. Carriers can then create an environment where their products are strategic assets against the actual risk to the population.

BST’s capabilities enable carriers to establish a point-of-view through “what if” scenarios regarding vendor selection, stop loss, and supplemental product decisions—all tethered to the overall plan design.

Problems BST is Solving for Medical Carriers

  1. Price Transparency
  2. Managing Risk
  3. Strengthening Distribution
Price Transparency

Carriers have next to no insight into the pricing arrangements of the competition. The BST Panorama tool, a new cloud-based software service, provides on demand access to pricing information and analytical tools to easily incorporate the vast data sets.

Managing Risk

Medical Carriers struggle to evaluate the true risk for an employee population. We use actual claims data as a second-look underwriting tool to either improve pricing or understand the risk not wanted unless priced properly.

Strengthening Distribution

Medical Carriers are looking to provide employers and consultants better access to their data and help optimize their medical plan. BST’s capabilities help to provide the risk analysis to create the right product bundles for an employee to select.

How We Support Carriers

  1. Data Warehouse
  2. Quality Analytics
  3. Descriptive Analytics
  4. Predictive Analytics
  5. Prescriptive Analytics
Data Warehouse

Carriers can provide partners with a robust data warehouse that captures more data than other platforms. Posting for a client’s benefit every 30 days, the capabilities include:

  • Accepting feeds from Benefit Administrators/Carriers.
  • Housing client-specific databases.
  • Normalizing for continuous in-depth data analysis.
  • Maintaining multi-period/lifetime storage/data blending.
Quality Analytics

BST solves the problems that many Major & Regional Medical Carriers face with data discrepancies, member matching inconsistencies, outdated data validations, and slow processing times.  BST’s technology allows for:

  • The utilization of advanced data science to ingest data into a modern engine.
  • Comparisons among data sets to measure the quality and rationale of newly ingested data.
  • Optimal machine learning-based approaches that maximize true member matches and identify hard-to-match records.
  • The leveraging of computer power and speed to load monthly files in under an average of 3 minutes.
Descriptive Analytics

BST delivers actionable business intelligence through customized financial and clinical reports. These provide customized views through key metrics of performance and cost, allowing carriers to:

  • Gain access to large data sets quickly. With our tools, employers will see fresh, relevant, monthly data quicker than competitors, with access to data within 30 days of us receiving it.
  • Uncover emerging risks throughout the year.
  • Better advise and hold vendor partners accountable.
  • Make unbiased, transparent, and cost-effective decisions.
  • Meet HIPAA/ERISA compliance standards with access anywhere through a secure (SOCII/SAAE16) cloud-based platform.
Predictive Analytics

BST stratifies risk, evaluates at a granular level, and identifies a health plan’s high-cost drivers. This allows carriers to:

  • Gain insight into advanced risk models that predict future high-cost claimants.
  • Implement a financial forecasting model that can identify the drivers of next year’s plan in an efficient, automated, unbiased, transparent, and cost-effective way.
Prescriptive Analytics

BST’s Plan Optimizer iterates billions of scenarios to arrive at an optimal plan design and prescribe specific actions, allowing carriers to:

  • Access cutting-edge plan optimization tool that solves for a best plan based on budget constraints and inform future plan design.
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