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5 Elements of Health

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Elements Health Plans program is unique. We are not a “corporate wellness program” and we are not a “claims analysis program.” We are an integrated health solution customized for each client based on need and culture.
While employers have had the benefit of management information tools like P&L accounts, balance sheets, production and maintenance reports, and sales pipelines, no equivalent tools to help manage employee health costs have been available— until now. Today Elements provides clients with knowledge tools and aggregated predictive data that provide a “health and well being fingerprint” of their population. By linking business drivers to the Employee Health & Lifestyle Management Program, Elements optimizes individual and corporate performance. Elements’ analytic tools allow management real-time insight into their current health plans, and offer accurate, actionable information for managing healthcare expenses the same way it fiscally manages every other aspect of the business. We call this Authentic Insurance. And we are the only consulting firm out there that provides it. Elements truly puts health back into health insurance.

How does the plan work?

1. We build your employer profile by identifying your needs and culture and leverag ing our proprietary Health and Lifestyle Assessment program along with our Health Plan Analytics Software .

2. Your employer profile is a working document used to design
the appropriate health benefits program, which integrat es health insurance with a pro active Health and Lifestyle Management Solution. Each employee has access to his or her own personal health assessment profile, a health coach, and the Five Elements of Health proprietary Lifestyle Management Program (see below for additional details).

3. You receive ongoing real-time Health Plan Analytics, which integrate the employee aggregate health assessment data with the health plan’s medical and Rx claims and utilization data, in order to gain a comprehensive and intelligent view of what is driving one of the largest line items on your bottom line.

Health Plan Analytics

Elements Health Plans data analytic tools simplify the way you approach benefits plan design— and set us apart from other benefits brokers. These tools:

• Benchmark your health and Rx plan data against national norms of similar employers using MedStat®
• MarketScan® data set
• Uncover the root causes of rising medical and Rx costs
• Offer plan design modeling tools, or "what if" analysis that helps you determine the effectiveness and magnitude of plan design changes
• Project health costs for high- costing claimants
• Provide complex information in an easy-to-use and easy-to-understand manner

Help you make faster and more effective decisions

The Health Plan Management Report exhibits include:

Total health plan cost ·  Total c laims by age category ·  Total claims by relationship ·  Total claims by network/PPO affiliation ·  Total claims by inpatient/ outpatient status ·  Place of service ·  High -cost claimants ·  Claimant distribution ·  Top hospitals and doctors ·  Inpatient hospital utilization ·  Inpatient days/1000 and payment/day ·  Top inpatient surgery p rocedures ·  Top o utpatient s urgery p rocedures ·  Office visit u tilization ·  Inpatient mental health utilization ·  Outpatient mental health utilization ·  Claims by major diagnostic categories ·  Lifestyle-related claims ·  Disease management and intervention opportunities ·  And many more!

You will also be able to integrate the “ Drill- Down” feature for prescription drug analysis (see below).

Drill-Down

Elements uses state-of-the-art online analytical processing, known as OLAP. This powerful querying engine formulates your data into robust "cubes" that allow it to be viewed in limitless variations. Elements Drill-Down can answer nearly any question you have about claims experience, including:

• Why are office visits so high? Who is going to the doctor? Why are they going? Are they using in-network or out-of-network providers?
• Why are my members using the emergency room so frequently? Who's using the ER the most — employees, spouses, or dependents? Are they using the ER appropriately?
• What does our experience tell us about disease management and about the intervention opportunities to select?
• On what types of wellness or educational materials should our employee communication campaigns focus ?
• What types of therapeutic drug classes are driving the prescription drug utilization?

Not only can we answer these questions and many more using Drill-Down, but we can find the answers easily— without knowing how to program or use a complex report-writer. The Drill-Down viewing tool makes use of intuitive, drag-and-drop technology for manipulating  the data easily. And, Drill-Down even allows us to create ad hoc charts and graphs for any exhibit.

Elements uses Drill-Down to analyze the following categories:

·  Claims history ·  High-c ost Claimants ·  Inpatient/ outpatient hospital ·  Inpatient/ outpatient surgery ·  Inpatient and outpatient mental health ·  Chiropractic care ·  Emergency Room ·  Lifestyle claims ·  Major diagnostic categories ·  Place of service ·  Disease management ·  Preventive services ·  Formulary utilization ·  Pharmacy provider ·  Utilization ·  And more!
Our tools allow us to model your plan based on a variety of plan elements, including in- and out-of –network claims for:
Calendar year deductibles Coinsurance Out of pocket maximums Office visit copay – Specialist and Primary Inpatient hospital copay Outpatient hospital copay Inpatient surgery copay Outpatient surgery copay Urgent care copays Wellness maximums Prescription Drug benefits Emergency room copay And many more variables

Elements can also predict the expected costs of catastrophic claims with a higher degree of accuracy than ever before. Our “Disease Profiler” can help you manage risk and narrow the probability of expected outcomes — critical needs that will ensure your health plan's continued profitability. By segmenting data to spot prevalence of disease, utilization, cost, or regional benchmarks, you will know what to expect of your member population.