Keeping high-quality healthcare accessible, while balancing the cost to both the organization and the individual, is a challenge requiring creativity and a firm grasp on the financial impact of plan design changes. By understanding the needs of a specific population and tailoring medical and prescription drug benefits to match those needs, you can deliver high-quality outcomes and reduce costs, all while ensuring compliance.
The Truven Health Benefit Modeler is an online tool that supports employers, health plans, and benefits consultants in the evaluation of a broad range of plan types including high-deductible health plans (HDHPs). Benefit Modeler alerts you if design scenarios are not compliant with Affordable Care Act (ACA) requirements for ER and preventive services and out-of-pocket maximums. It also supports HHS Minimum Value Calculator reporting, making Benefit Modeler a “one-stop” resource for plan design validation by including the values needed to produce a pass/fail report for each plan option.
The Truven Health Benefit Modeler provides the information you need to answer such questions as:
Benefit Modeler's easy-to-use interface allows you to confidently make benefit plan design decisions specific to your situation. The model is based on data from our proprietary Truven Health MarketScan® Commercial Claims database, representing 36 million lives and all 50 states. Using actual claims cost and use experience, industry group, enrollee age/gender, and geographic distribution, we tailor the modeling results to your specific healthcare experience.
Transformational healthcare solutions from Truven Health Analytics are now offered by IBM Watson Health