Financial Risk Management:
Unmatched Level of Accuracy in Underwriting Health Lines of Business
Prealize Health’s Financial Risk Management solutions bring a new level of accuracy to underwriting, and stop-loss. Prealize empowers you to predict and control financial risk more effectively. Our solutions enable precision underwriting for fully insured, level funded, PEO’s and stop-loss —both for new business prospecting and renewal decisions—by identifying key cost drivers and proactively communicating them along with programs and solutions to manage trends.
At the heart of our Financial Risk Management solution is RiskInsight, our powerful predictive analytics tool designed specifically for underwriting renewals, prospecting, and stop loss.
Key Features:
The Building Blocks of Precision
Comprehensive Assessments:
MetisAI predicts total claims, excess claims, clinical drivers and more at the group level. Insights that give underwriters and employer groups tools to quickly review financial risks and understand primary drivers
Individual Renewal Drill Down:
Pinpoint future clinical drivers and costs to the individual level, providing tools to assess risk accurately and an opportunity to contain preventable costs through partnership with care management
Predictions Aligned With Your Business:
We can create custom predictiions and have the flexibility for our model to learn from your claims experience and program results
Data-Driven Recommendations:
Move beyond generic solutions for employer groups. Offer personalized program recommendations with precise impact forecasts, showcasing your commitment to client success
Benefits:
Accuracy that Translates to Value
Increased confidence in identification of future spend and rising risk with actionable insights
Risk Scores and PMPM predictions, clinical conditions and ED/IP utilization patterns
Optimized financial planning (e.g., underwriting, employer groups, or book of business risk assessment)
Differentiated client relationships, driving growth and retention
Earliest identification for care/condition management intervention
Use Cases:
Furthering Every Client Interaction
Annual Client Reviews:
Go beyond the basics with highly accurate year-over-year health trend analyses that impress and inform
New Business Pitches:
Differentiate your offerings with precise risk and cost projections that leave a lasting impression
Program Performance Reporting:
Showcase ROI with accurate before-and-after comparisons, proving the value of your recommendations
Strategic Planning Sessions:
Guide clients through data-driven, highly accurate future health scenarios, positioning yourself as a strategic partner in their success
Financial Risk Management:
Demonstrated Client Value
Proven Results:
Real-World Impacts
We are driving the revolution of moving from reactive to proactive, producing lower costs and better outcomes.
$87M
Discovered in previously unidentified rising risk, accounting for 35.8% of actual costs that year.
>61%
Predicted of all future high-cost claimants who would exceed $200K in medical and drug costs, compared to 55% identified by the incumbent solution.
Prealize’s predictions were far superior. Engaging with Prealize accelerated our ability to further improve health and lower costs for the long term.
VP, Informatics & Analytics
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Discuss how Prealize can bring a new level of precision to your financial risk management strategies.