Real-Time Analytics and Matching

The number of plans and the changes to plans is rapidly increasing. The volume of claims and claims-related data is growing exponentially. New providers and types of providers are added daily. And amidst all this data change, payors are pressured to negotiate better contracts and plans with information that seems less meaningful each year.

Some payors struggle with the ability to do effective predictive analysis of the impact of changes to tariff codes and contracts. The problem becomes more acute when negotiations involve separate contracts for physicians, pharmacies and labs. For example, many new “companion drugs” are prescribed by physicians and must be accompanied by a series of diagnostic tests. One group negotiating a formulary can create additional cost for another group negotiating with labs without their knowledge.

As a Premier IBM Business Partner, IMT uses the IBM Big Data and Predictive Analytics tools to create solutions for payors. We can work with you to create an economic forecasting model that puts you in a position of power during negotiations by knowing what impacts to your organization and what could occur under different scenarios.