— Service
Plan Performance & Risk Trends
Track and understand your risk trajectory over time with clear analytics. Most employers only look at cost once a year — at renewal. We help you monitor performance continuously, so emerging cost drivers are caught early, not after they’ve compounded.
— The Problem
By the Time You See the Renewal Number, It's Already Too Late
Cost trends don’t appear overnight. They compound quietly — a few large claimants here, a new specialty drug there, utilization creeping up — until the renewal hits. Employers who track performance continuously catch these trends 6–12 months earlier and have time to act.
- Most employers review plan data only once a year — at renewal
- Emerging large claimants go unmanaged until stop-loss triggers
- Utilization shifts (ER overuse, specialty Rx growth) compound unnoticed
- Year-over-year trend analysis is reactive, not predictive
Large Claimants
High Risk
2–5 members driving 30–50% of total plan cost with no clinical management
Specialty Rx Trend
High Risk
+22% YoY growth in specialty drug utilization with no formulary controls
ER Utilization
Med Risk
Non-emergency ER visits running 45% above peer benchmark
Network Leakage
Low Risk
Out-of-network utilization at 8% — within acceptable range but worth monitoring
— Deep Dive
What We Track & Analyze
not just where it’s been
01
Claims Trend Analysis
Month-over-month and year-over-year claims trends broken down by category — medical, Rx, inpatient, outpatient, ER — to surface where growth is accelerating.
02
Large Claimant Monitoring
Identify and track members exceeding stop-loss thresholds. Understand clinical trajectories and assess whether care management interventions are effective.
03
Risk Score Modeling
Aggregate population risk scoring to predict future cost — factoring in chronic condition prevalence, age/gender mix, and utilization patterns.
04
Utilization Trend Tracking
Track ER visits per 1,000, admission rates, surgical volume, preventive care participation, and telehealth adoption over time.
05
Cost-Per-Member Trajectory
Monitor PMPM cost trends and compare against national, regional, and industry-specific trend benchmarks to assess relative performance.
06
12–36 Month Forecasting
Project where costs are heading based on current trend data — giving leadership the lead time to make proactive decisions, not reactive ones.
—PROCESS
How Performance Tracking Works
01
Baseline Assessment
We establish your current performance across all key metrics with 24 months of historical data.
02
Ongoing Monitoring
We track trends monthly or quarterly — surfacing emerging risks before they compound.
03
Strategic Adjustments
We recommend proactive changes based on what the data shows — not guesswork.
— What You Get
Expected Outcomes
Early
Detection of emerging risks
Predictive
12–36 month cost forecasts
Proactive
Strategy adjustments, not reactive
Fewer
Renewal surprises
— Related Services
Explore Other Services
Do You Know Where
Your
Plan Is Heading?
Most employers don’t — until renewal. Start with a 15-minute conversation and we’ll show you what the data says.