Poindexter's Points:
Advanced Plan for Health's News and Updates

July 2018
In The News
Podcast: How Employers can Avoid Hidden Medical Expenses with Joy McGee-Cory from Advanced Plan for Health

We are very pleased to share that Joy McGee-Cory was featured in an Employee Cycle podcast that went live in June . Follow this link to listen to the podcast recording of Joy discussing how employers can analyze employee benefits data to identify hidden medical expenses to save costs.

Here is some of what you’ll learn from this podcast episode:

  • Why educating employees about appropriate use of the emergency room is important.
  • Why over-utilization of medical benefits should be watched closely.
  • Why it’s important to know if your medical plan is promoting both generic and brand name drugs to your employees.
  • Why it’s important to know who is receiving pharmacy rebates from drug manufacturers.
  • How to leverage analytics around your benefits utilization rate to identify potential savings.

Click here to listen to the full podcast.

We are pleased to share that the Self-Insured Institute of America (SIIA) has approved us sharing their important write-up with our e-newsletter audience. The article covers the Right to Try Act (RTT) . It covers the many considerations, responsibilities, inherent risks and benefits of these alternative treatments. Here is an excerpt:

“In late-May, Congress passed, and the President signed in to law, the Right to Try Act, which gives terminally ill patients a direct pathway to access experimental treatments that have not yet been approved by the Federal Drug Administration (FDA). This new federal law largely follows the nearly 40 states that have already passed a version of Right to Try (RTT) over the last four years…

…RTT is meant to be an alternative treatment process for the few patients who do not qualify under the current FDA Expanded Access program. This FDA program allows patients, with physician approval, to ask the FDA and drug companies for access to experiment drugs…

…RTT is aimed at allowing terminally ill patients access to experimental drug therapies that have successfully completed an FDA Phase I clinical trial, but have not yet completed Phase II, III, nor received FDA approval…

…Under RTT, a physician would have to approve of the use of an experimental drug and ask the drug manufacturer for approval to use on behalf of the patient. The drug manufacturer can approve or deny the request…” 

The article goes on to provide more details on RTT and what it means for Self-Funded Health Plans.

To continue reading click here .
Recap From The Road
The Advanced Plan for Health team was honored to participate in this year’s Corporate Synergies Group client innovation events (called The Current Events ) which took place at various location throughout the Northeast region of the U.S. over the last couple months. 
These events were full-day forums of exceptional health and welfare benefits and business insurance speakers whose insights provided attendees an array of unique perspectives on how to gain control over top-of-mind industry situations and improve outcomes.

APH’s Rick Scheel, VP of National Sales, attended several of the Corporate Synergies events as a representative and presenter for APH. Rick felt honored to have been a part of the event faculty, and he learned from industry leaders whose knowledge, experience and savvy perspectives provided a deeper understanding of the challenges facing our industry and our clients and prospects. Rick’s key learnings from these events are recapped in the paragraphs below.

The Current Events were well attended and had a keen focus on helping employers to improve both health and financial outcomes. Many of the speakers addressed the growing need to have a powerful healthcare informatics solution in place to deliver missing insights into areas of opportunity. A substantial number of the presentations covered topics that aligned closely with Advanced Plan for Health’s solutions. For example: 

Dr. A. Bartley Bryt from Brighton Health Plan Solutions and Dr. Joel Shu from Catholic Health Solutions led a powerful discussion regarding the value that comes from plans working with an integrated health system to provide not only improved price performance, but also improved quality. Not long into the presentation, it became clear that Plans must focus on both unit cost and utilization. Having insights into both elements is critical to arrive at the best overall value.
In another session, Mr. Steve Kelly, CEO and Founder of ELAP Services described the historical network discount shell game as well as the industry’s paradigm shift toward reference-based pricing. Mr. Kelly expressed that having a strong analytics partner who can readily identify areas of opportunity is critical for understanding future financial impacts and the effects that a shift to this type of plan structure would have on the plan’s performance. Health Plans, providers and plan sponsors are increasingly seeing the value of paying for services rendered based on a base fee structure, such as Medicare Allowable, as opposed to a discount off of billed charges.

During APH’s presentations of the Poindexter platform at a couple of the events, one common response from attendees was to express how impressed they were with the level of empowerment Poindexter makes available to the end-user by providing access to data in a user-friendly, structured, and readily customizable format. They expressed the value of Poindexter having a timely and easily accessible view of dashboards, Opportunity Assessments and areas for improvement for self-funded accounts.
About Corporate Synergies

Corporate Synergies is a national insurance and employee benefits brokerage and consultancy. They operate from the headquarters in Mount Laurel, New Jersey; and has regional offices in New York City and Melville, New York; Bethesda, Maryland; and Orlando, Florida.
Please contact your APH account representative or email marketing@mypoindexter.com if you would like APH to participate at your next client event.
Also, for any further questions related to Rick Scheel’s experience and learnings at these conferences, please feel free to reach out to us at (888) 600-7566 or marketing@mypoindexter.com .
Blog Insights
In June, we were fortunate to have our lead Data Scientist, Jason Rudy, and Programmer, Matt Lewis publish a second blog post related to Artificial Intelligence and Machine Learning in healthcare. Their insights and perspectives are something we are glad to be able to share. For our second blog post of the month, we tapped into insight from our VP of Clinical Operations, Dr. Barb Rutkowski.

Jason Rudy, Data Scientist / Programmer and Matt Lewis, Programmer / Product Manager

In a previous blog post, we walked through the process of building a predictive model using healthcare data. One of the things we touched on briefly there, was how important proper feature engineering can be to creating a useful representation of the underlying data, and how the choices made around shaping data into features can change the nature and performance of the resulting model. 

In this post, we’ll be going deeper into the process of feature engineering, and how to convert raw data inputs into a form that will make machine learning not only possible, but effective. 

To continue reading click here.

Barbara Rutkowski, EdD, MSN, CCM - Vice President, Clinical Operations, Advanced Plan for Health

A lot has happened since Alexander Fleming accidentally discovered Penicillin in 1928 after a chance exposure of staphylococcus to penicillin mold. For his discovery, he won the Nobel Prize after penicillin was commercialized in 1945, used successfully for war wounds and surgery in World War II and hailed as the “miracle drug”. In his acceptance speech, Fleming admonished the world to beware that bacteria would become resistant in time.

To continue reading  click here.
APH, On the Road
Upcoming Tradeshows and Conferences

July 16-18 l Minneapolis, MN

The HCAA TPA 2018 Summit focuses on the information and process needs of benefit administrators and the self-funded industry. It additionally offers break-out sessions for attendees in Leadership, Sales/Marketing, Operations and Emerging Leaders paths. 

September 23-25 l Austin, Texas

The SIIA National Conference & Expo is the world’s largest event focused exclusively on the self-insurance / alternative risk transfer marketplace and typically attracts more than 1,700 attendees from around the U.S. and from a growing number of countries around the world.
The APH team would welcome the opportunity to meet you in person at any of our scheduled tradeshows and conferences. Contact us here , email us at marketing@mypoindexter.com or call (888) 600-7566 to arrange a time to meet with us.