PlanWell Health: Improving Care Outcomes, Lowering Costs

PlanWell Health is the first member care app to utilize actual medical and pharmacy claims data of plan members to close gaps in care and save healthplan dollars.

Once care gaps and health intervention opportunities are identified, PlanWell then uses the principles of the most independently researched and peer reviewed population health effort in existence called The Asheville Project.  For nearly 25 years this approach has been used to improve the health of members and save plan costs.

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Utilizing Medical Claims Analytics

Prevention
Gaps in Care

Tracking needed preventive health procedures on an automated basis from health plan claims data.

Chronic Condition
Gaps in Care

Track progress towards managing chronic conditions and see how your health risk changes over time.

Missing Prescriptions
Gaps in Rx Care

If you are missing a prescription that is often used to manage a chronic condition, we will alert you.

Based on The Asheville Project

The Asheville Project approach involves identifying and closing gaps in care to improve member health.  Below are links to various peer reviewed clinical outcome studies.

Hypertension.  5 Year, 6200+ Patients

  • 53% decrease in risk of cardiovascular event
  • 50%+ reduction in risk of related cardiovascular emergency department visit
  • 31% reduction in medical costs related to cardiovascular patients

Diabetes Study.  5 Year, 200 Patients

  • Total direct medical cost decrease $1,200 to $1,872 per patient per year
  • Estimated productivity increases estimated at $18,000 annually

Asthma Study.  5 Year, 200+ Patients

  • Total direct medical cost decrease $725 per patient per year
  • Indirect cost savings estimation of $1,230 per patient per year
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How We Identify Gaps In Care

PlanWell Health helps identify individuals with chronic conditions, as addressing any gaps in their healthcare is crucial for both prevention and effective management of these conditions.

The data science team at PlanWell also utilizes the claim analytics functionalities of our healthcare claims management software to gain insights into the claims occurring on your self-insured health plan, such as identifying low-quality care providers being accessed, overuse of emergency room, increase in overall population risk for 15 different chronic conditions, generic drug substitution opportunities, and much more.

Improving Member Health and Controlling Plan Cost

Identify and engaging members with chronic conditions and gaps in care for prevention, pharmacy and chronic condition management.

When healthplan members have missing prevention services or fail to follow the necessary recommended protocols to care for a chronic condition, it is important to their health and the costs of your plan to close the gaps. 

We begin by leveraging your self insured plan claim data analytics through our integration with Self Insured Reporting, thus accessing all of your members health plan claim data and metrics. Next we scan for opportunities of improvement and personalize these insights on behalf of each plan member.

Once care gaps and health intervention opportunities are identified, PlanWell then uses the principles of the most independently researched and peer reviewed population health effort in existence called The Asheville Project.  For nearly 25 years this approach has been used to improve the health of members and plan costs.

Leveraging Claim Data

Medical and pharmacy claims data is used to target members for better healthcare

Medical and pharmacy claims data is used to target members for better healthcare

Condition Targeting

Search chronic conditions or trigger diagnosis claims, select members and target applicable messaging to the entire group of members.

Prescription Drug Targeting

View all healthplan drug claims, select any drug to view all members with filed claims, and directly target savings opportunities.

Procedure Based Targeting

Search any procedure to view members with filed claims or those with missing claims and directly target only those members.

Healthcare Provider Targeting

View all healthplan provider claims, select any member or provider to view all filed claims, and directly target opportunities.

Healthcare Management App Reviews

The Markplace Feedback has been tremendous across the board

You are Changing Healthcare

I guess you never know what you are missing until something like PlanWell Health comes along and once you see it and understand that is happening, you know that something fundamental just changed.

Intervention is Critical

As an employer if we are ever going to move the needle in terms of costs, we must engage employees and have strategic interventions that provide them exactly what is needed to improve their health.

What People Say

The Markplace Feedback has been tremendous across the board

21st Century Benefits

You guys are changing the way that benefits are communicated and delivered.  Most app based technologies focus only on communication but through your interventions we can show a measured ROI.

Leveraging Claim Analytics, Brilliant!

Personally, I’m most impressed by how you have linked the claim analytics of the plan directly back to the member.I’ve never seenthat before, but it makes a lot of sense and that is where things like gaps in care belong, in the hands of someone who can do something about it.