AMS (Advanced Medical Strategies)

Join AMS Thursday, July 25 2024, 02:00 PM - 03:00 PM EDT for our July Profiler Power Up Session: Profiler Release | Advanced Risk Analysis Model. The Profiler Power Hour is a dynamic platform designed to discuss, educate, and empower our Profiler clients each month. This month dive deep into the innovative Risk Analysis model for medical underwriting, introduced at AMS’ annual conference. Discover how Profiler actively stratifies Moderate, Emerging, and High-risk members within a group's data, enhancing underwriter accuracy, effectiveness, and efficiency in risk identification. Don't miss this opportunity to learn valuable techniques and best practices that will enable you to harness the full potential of Profiler. Register below and feel free to submit any questions you may have. We look forward to seeing you online! https://lnkd.in/ex6pZWW7

As promised, here are some additional thoughts on how employers can use health data/analytics partners (e.g., Merative, Springbuk, Artemis by Nomi Health, 4C Digital Health, Health Data & Management Solutions, Inc. (HDMS), Certilytics, AMS (Advanced Medical Strategies), Tuva Health) to better manage their benefit plans and fulfill their fiduciary responsibilities. My advice is that these organizations incorporate analytics that specifically address potential friction points with employees and that could lead to legal action similar to that faced by J&J. Currently, the primary focus of these systems has been on trend analysis, benchmarking, cost, and utilization. As these system evolve, they need to include capabilities to identifying plan design and vendor performance opportunities. These may include differences in pricing and reimbursement (e.g., PBM contracts), detecting fraud and abuse, conducting "lite" dependent and claims audits, and assessing health equity. An optimal new functionality would be a quasi-automated fiduciary-specific report that becomes a part of the fiduciary committee's documentation process. This feature should not require users to run multiple reports and manually piece them together. Instead, it should provide responses to curated questions and prompt users for inputs, when appropriate. Here are some examples: > Are per member plan costs consistent with industry benchmarks? > Are plans priced fairly, ensuring that members who choose richer plans pay the full incremental costs? > Are plans affordably priced? (Plan costs as a percentage of salary) > Is the employer actively evaluating and managing vendors? - Risk-adjusted plan costs - Quality metrics - High cost claimants - Outlier conditions > Are the plans paying claims only for eligible employees and dependents? > Do the claims indicate that the TPA is adjudicating claims according to the Summary Plan Description (SPD)? If not, has a full claims audit been completed recently? > Have specific programs (health plans or point solutions) been implemented to address areas of high costs or increasing trends, such as diabetes, cancer, maternity, or musculoskeletal issues? This type of report would provide timely and significant value to users of these health data reporting systems. I encourage your comments. Pointe Consulting LLC, Blake Zenger, MBA, Fiduciary In A Box

AMS (Advanced Medical Strategies) is a proud sponsor of the 13th Annual Century Ride, supporting UnitedHealthcare Children’s Foundation. The Century ride took place on Saturday, July 20, 2024 in Eden Prairie, MN. To date, $720,917.00 USD has been raised for providing medical grants for children in the Central Region. We could not be prouder to serve this community and support our partner, United Healthcare in this cause.  Thank you AMS Team Allison Condon, MSN, RN and Nicolas Andre for participating!   If would like to donate: https://lnkd.in/e8Rkz2Qi

AMS (Advanced Medical Strategies) is back from the Health Care Administrators Association (HCAA) TPA Summit in St. Louis! It was a great event filled with insightful discussions, innovative ideas, and valuable connections. We're eager to continue the conversations with the connections we made and keep driving excellence in our industry. Thank you to everyone who made our time at the summit a success – we look forward to seeing you all at the next event! Tyler Benware Ronnie Shul

AMS (Advanced Medical Strategies) is thrilled to announce the integration of Liviniti rebate information into our PredictRx module. Clients can now effortlessly view the price of a medication and available rebate with just a click of the “Rebates Available” link. This feature, powered by Liviniti's RxCompass, helps save significantly on specialty and high-cost medications by leveraging prior authorization and claims data to guide members to the most cost-effective options.    AMS continues to innovate, ensuring our clients receive exceptional value. If you would like to learn more about how AMS is transforming healthcare savings, please contact us at info@amspredict.com   #HealthcareInnovation #CostSavings #AMS #Liviniti #PredictRx

AMS (Advanced Medical Strategies), the premier provider of payment integrity, risk management, and business intelligence solutions, is pleased to announce a strategic partnership with Amalgamated Life Insurance Company, a leading provider of comprehensive insurance benefits and solutions. As part of this partnership, Amalgamated Life will leverage AMS' Predict Platform, including Profiler and CensusRater, to enhance its data analytics capabilities and drive informed decision-making in the healthcare industry. By harnessing predictive analytics and data visualization, this partnership aims to optimize performance, reduce costs, and improve patient outcomes. For more details, please read the attached press release.

AMS (Advanced Medical Strategies) will be closed on July 4th and 5th in observance of the holiday. We hope everyone has a safe and enjoyable break!

AMS (Advanced Medical Strategies) will be in attendance at the Health Care Administrators Association (HCAA) TPA Summit in St. Louis, MI from July 15-17! For several years, AMS has been at the forefront of hospital and health plan price transparency. We proudly support large and specialized TPAs with our cutting-edge clinical, financial, and data analytics solutions. If you’d like to schedule a meeting with our team during the summit, please contact Tyler Benware, VP, Stop Loss Solutions | tbenware@amspredict.com or Ronnie Shul, Sr. Business Development Representative | rshul@amspredict.com. We look forward to connecting and exploring potential collaborations! #HCAA #TPAsummit #PriceTransparency #AMS #DataDrivenSuccess

Exciting News from AMS! Check out this post from AMS (Advanced Medical Strategies)' Co-Founder & CEO Peter Borans about the upcoming launch of a new feature within PredictDx. By integrating price transparency data from PredictPx, we're enhancing cost of care, payment integrity, and risk management insights. Watch the video for more details! If you would like to learn more about PredictDx or PredictPx, contact us at info@amspredict.com or visit www.amspredict.com #HealthcareInnovation #PredictiveAnalytics #PriceTransparency

Take a look at this post from AMS (Advanced Medical Strategies)' Vice President of Stop Loss Solutions Tyler Benware. During our recent annual conference, a client shared how Profiler helped during renewals: "Profiler has transformed our data processing, reducing the time from two weeks to just two days. This efficiency not only saved us over 100 hours but also improved our underwriting accuracy and reduced stress during renewals. Profiler has been a game-changer for our team." The choice is yours this renewal season! Please contact Tyler with any questions at tbenware@amspredict.com