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HealthComp’s High-Touch Clinical Programs for Members Prove Valuable, New Independent Study Finds

EINPRESSWIRE

Wakely researchers compared cost savings and utilization to industry averages to assess the effectiveness of HealthComp’s care management programs.UNITED STATES, April 5, 2022 /EINPresswire.com/ — A new report from HealthComp, the nation’s largest third-party administrator (TPA) and a New Mountain Capital Company, details how HealthComp drove compelling financial outcomes and cost savings for its customers, as evidenced by its 2019 medical claims. Independent researchers specifically found new evidence about what makes HealthComp’s clinical care management effective and efficient.

This analysis, conducted by the independent actuarial firm, Wakely, was adjusted for both risk and geography. Researchers found those who adopted HealthComp’s clinical care management programs saw 19% lower medical costs compared to the industry average and 30% lower utilization (i.e., the number of healthcare services administered for a given population).

“Waste in healthcare is no secret. The future of health benefits administration is about eliminating waste to re-invest savings towards improving the lives of entire employee populations, their families, and communities,” said Justin Tran, HealthComp’s Senior Vice President of Medical Cost Management. “One of employers’ highest business spends is on health plans, which averages $10,000 annually per employee. Our research demonstrates how important it is for health plan administrators to serve as plan members’ human touchpoints and advocates. Doing so better directs plan members to appropriate care and reduces unnecessary procedures and costs – by up to 30%, according to this empirical research,” he emphasized.

Five Key Findings
• Utilization – 30% lower overall utilization, including 14% lower outpatient utilization, by engaging members and improving treatment selections favoring lasting health results.
• Inpatient costs – Inpatient-allowed costs were 48% lower (representing $14.25 per employee per month, or PEPM, in savings) by helping members with chronic conditions sustain habits to avoid acute exacerbations and prevent readmissions.
• Emergency Room Solution Services – 32% lower emergency room utilization (representing $16.09 PEPM in savings) by rapidly aiding members to find alternate sites of care after single non-emergency visits.
• Radiology – 27% lower radiology/lab spending by engaging members and their care teams early to achieve optimal diagnostic intensity.
• Mommies 2-Be Program – 40% lower maternity spend by improving the rate of full-term pregnancies and supporting mothers with postpartum symptoms.

“These findings are profound for both the greater TPA industry and the health plan industry at large. More efficient, effective, and affordable healthcare is simply a dire necessity in today’s overburdened health systems. Our research provides hope for what’s possible,” said Paul Johnson, HealthComp’s Vice President of Clinical Services. “Thanks to continual in-house cost containment service investments, HealthComp has built distinctive solutions aimed to increase better clinical outcomes for members while keeping medical costs low.”
With greater staffing and deeper technology, HealthComp creates results-driven member engagement and runs a full suite of in-house clinical care management programs. Here, collaboration with members and their physicians drives optimized decision-making and increases care delivery quality. Most HealthComp employer clients – 90% – choose HealthComp’s clinical services, which include utilization review and pre-certification, case management, disease management, population health, proactive cancer awareness, lower-cost emergency room solutions, and personalized prenatal programs. Together, these programs help participating clients mitigate costs and improve care outcomes.

For more information and to read the research in full, visit Actuarial Report: The Value of HealthComp’s Clinical Care Management and Claims Excellence https://healthcomp.com/clinical-care-management/.

Carrie Williams
HealthComp
+1 800-442-7247
cwilliams@healthcomp.com
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Chad Harris

Chief Executive Officer

 

Chad Harris serves as the CEO of HealthComp and is a value-driven healthcare leader with over twenty years of experience running business process and information technology businesses as a senior executive. Chad has a reputation for creating and controlling rapid growth by focusing on the intersection of customers, market dynamics, and the new digital world.

 

Chad has held many senior executive positions and led global teams of more than 10,000 people across dozens of counties. Chad has grown both large and small businesses, from those with less than $100M of revenue to those producing multiple billions of revenue, focusing on delivery, customer satisfaction, and innovation to create market leadership.

 

Chad's philosophy is to inspire change by doing what comes naturally, putting the needs of others before his own, working incredibly hard, and focusing on "how" to accomplish things, never "if they can be accomplished."

Thomas Martel

Chief Growth Officer

 

Tom serves as the Chief Growth Officer at HealthComp. In this role, Tom focuses on strategic initiatives aimed at accelerating HealthComp’s growth nationwide. His passion lies in assessing market and enterprise structures and creating efficiencies that enable teams to deliver best-in-class performance.

 

Previously, Tom led Cigna’s largest employer segment, largest region which was comprised of several health plans including the two largest health plans. He worked closely with Market Presidents and their leadership teams to develop and execute local market strategy and deliver growth for the enterprise. Tom earned his degree from Saint Anselm College and holds certifications from The Wharton School and the Darden School of Business at the University of Virginia. In his spare time, he enjoys sailing and holds a Master Captain’s license with the U.S. Coast Guard. He is also active in community outreach programs including local food bank and shelter services.

Sanoj Balakrishnan

Chief Technology Officer

 

Sanoj Balakrishnan serves as the Chief Technology Officer at HealthComp. In this role, he oversees the company’s overall technology strategy and architecture, building secure and highly scalable distributed systems.

 

Most recently, Sanoj served as Head of Healthcare Digital Business and Technology at Cognizant, working with payers and providers in developing solutions that reduced healthcare costs and provided a best-in-class experience for members. Earlier in his career, he worked at technology organizations in a variety of software engineering and architecture roles. Sanoj earned his B.S. from University of Mumbai and Computer Systems Management from National Institute of Information Technology.

Justin Tran

Executive Vice President, Product

 

Justin serves as the Executive Vice President of Product at HealthComp. He has 8 years of experience in developing and delivering solutions that reduce health care costs, improve quality, and provide a best-in-class experience for members. Most recently, Justin was an Associate Partner and business unit leader at McKinsey & Company where he helped large carriers and healthcare technology companies build new clinical services and solutions for fraud, waste, and abuse. Justin earned his B.S. in Accounting and Data Informatics from Indiana University, Bloomington.

Tucker Stein

Chief Financial Officer

 

Tucker serves as the Chief Financial Officer of HealthComp. Tucker previously worked for The Boeing Company in a number of finance and strategy roles, most recently as a finance lead for the Transactions and New Business Development group. In this role, Tucker led investments and strategic partnerships for Boeing’s Space and Communications portfolio. Tucker earned his MBA at Stanford’s Graduate School of Business and his Bachelors of Science at the University of Redlands.

Tom Georgouses

General Counsel

 

Tom is involved in multiple areas of HealthComp including Operations, Compliance and Legal Affairs. Tom was admitted to the California Bar in 1990 and started his legal career with Stammer, McKnight, Barnum and Bailey, LLP. When he left the firm to join HealthComp in 2014, he was the Managing Partner (he had represented HealthComp since 2003). In private practice, Tom’s areas of focus included healthcare and transactional work. Tom holds a Bachelor of Science Degree in Business Administration-Finance from California State University Fresno and received his Juris Doctorate from San Joaquin College of Law.

Rishab Bansal

Chief Transformation & Operations Officer

 

Rishab serves as the Chief Transformation & Operating Officer at HealthComp. Rishab focuses on transforming and modernizing HealthComp’s operations to provide delightful and distinctive experiences to its members, providers, and clients. His agenda includes integrating all entities towards a One HealthComp vision, driving profitable growth, and delivering value and business outcomes.

 

In his former work over the last 2 decades, he has helped clients across industries to transform themselves by bringing industry-leading practices and digital and data-led disruption. As the trusted advisor to the C-suite, Rishab helped his clients leapfrog on their transformation journey to accelerate business outcomes and helped them unlock new opportunities to drive profitable growth, profitability, and enhanced experience for their employees and clients.


Elaine Davis

Chief Human Resources Officer

 

Elaine Davis serves as CHRO for HealthComp. Elaine previously served as CHRO for Continuum Global Solutions and has served in executive leadership positions for Xerox and GlaxoSmithKline. Elaine holds Bachelor’s and Master’s degrees from the University of California at Berkeley.