Healthy Solutions from American Health Data Institute

The American Health Data Institute (AHDI) is a data warehouse and targeted utilization management partner that combines all the necessary elements for controlling healthcare costs from both the demand and supply side of the healthcare equation. AHDI utilizes information provided by the employer including medical claims data, eligibility records and pharmacy as the source data. The AHDI data warehouse utilizes very sophisticated software to analyze the variances, cost drivers, cost trends and other significant clinical and financial factors that influence the costs of a health plan. Ordinary claims data is transformed into powerful, actionable intelligence.

What Answers AHDI Provides:

AHDI can identify the factors driving healthcare cost increases. AHDI will identify excess healthcare costs driven by illness burden, provider variances in cost and practice patterns, as well as demographic challenges.

AHDI Helps BPA Deliver Cost Containment Solutions:

• Health risk assessment tool: Key Care Guide
• Chronic disease management program
• Predictive modeling and risk stratification
• Comprehensive reporting to analyze clinical and financial factors

Health Risk Assessment - Key Care Guide:

AHDI has established an interactive personal Health Management System designed to educate employees and spouses about their health risks and identify areas that can improve their health status.

Developed in partnership with Duke University Medical Center, this system enables employees to access a health management system that includes:

• A Personal Health Assessment
• A Personal Health Chart
• A Health Index Comparison Chart
• A Health Concern Report
• An Exercise Log
• A Medical Encyclopedia with extensive custom designed educational tutorials

Employers benefit from the easy implementation of this system and the ability to track and measure member activity and results.

Chronic Disease Management Program

AHDI will identify and track the 20% of an employer’s population driving 80% of the cost of the health plan – those with chronic conditions. Once these members are identified, a Healthcare Navigator Nurse Coach contacts each member via telephone. The nurse educates the member about their chronic condition(s) and what type of care they should be receiving to manage the condition. AHDI will then track whether the member meets minimum standards of care.

The AHDI Chronic Disease Management program is designed as an opt-out program that typically results in less than 2% of members choosing not to participate.

AHDI monitors 19 different chronic conditions. The Healthcare Navigator Nurse Coaches will assist members in navigating through a complex healthcare system, provide educational resources and encourage those members to use high quality, cost effective providers.

Predictive Modeling and Risk Stratification

AHDI utilizes a Predictive Risk Model to rank individuals from having the greatest probability of disease onset to the least probability. The Predictive Risk Model utilizes sophisticated software to take the following factors into consideration to assign a Healthcare Index…

• Age/gender
• Illness burden
• Co-morbidities
• Types/frequency of medicines

AHDI Reporting Package

The employer will receive both ERS (Executive Reporting System) and AHDI reports. These reports are uniquely assembled to provide an employer with actionable data. The reporting analysis provided in this package will answer all critical questions in order to identify and control healthcare costs. The analysis covers clinical, financial and benefit design factors of a health plan. These reports compare an employer’s data to normative and regionally relevant data. When claims data is analyzed succinctly it becomes much easier for an employer to control and manage healthcare costs. These reports provide benchmarks, accountability measures and critical indicators.

What Employers Can Expect From These Tools

An employer has a very important role to play in the effective implementation of these tools. AHDI and BPA partner with the employer to structure effective communications that empower members to be better consumers of health care. In addition, employers who implement meaningful incentives that encourage members to seek appropriate care and to utilize tools such as the health risk assessment realize optimal value from these tools, including the following positive outcomes…

Savings – The typical savings for an employer who effectively implements the Chronic Disease Management Program is about 5% of medical claim dollars – usually translating into about a 6:1 ROI. An employer with the ability to utilize physician-profiling data to steer members to high quality, cost effective physicians can often save between 2-10% of medical claim dollars.

Data – Many employers currently lack actionable data to control health care costs. AHDI provides comprehensive, results-oriented reports for responsible management of the health plan.

Risk Coordination – Employers can reap the benefits of more proactive risk identification and risk management by using the Healthcare Navigator Nurse Coaches and Predictive Modeling.

Consumerism –The right educational tools and appropriate information can engage employees and help them make wiser healthcare decisions.

Let BPA Help You Adopt a Winning Wellness Strategy

Shaping a culture of wellness and helping everyone take control of health care costs is a comprehensive process that begins with understanding how your employees feel about their health and their benefits. By partnering with AHDI, Benefit Plan Administrators can help your company identify the wellness strategies, incentives and employee communications that will yield the greatest return on investment for your organization and the employees you depend on.