ANN ARBOR (WWJ) – Truven Health Analytics announced a partnership with Clearwater, Fla.-based Wakely Consulting Group to deliver a comprehensive set of products and services designed to help health plans comply with Affordable Care Act reinsurance and risk adjustment programs.
Combining industry-leading data management and analytics with proven healthcare actuarial consulting and risk modeling capabilities, the new risk management solution allows health plans to meet the Department of Health and Human Services requirement to have an edge server infrastructure in place by fall 2013. It also allows health plans to proactively forecast the potential impact of ACA risk scoring and optimize their risk.
The combined Truven Health and Wakely Consulting risk management system uses the Truven Health MarketScan Research Databases, which contain de-identified health care claims data reflecting the real-world medical care of over 180 million unique patients across the United States. HHS used this same database to develop their risk model for assessing health plan risk profiles, which will ultimately drive risk transfer payments. The solution will also process data through the Wakely Risk Assessment Model, which employs the same methodology HHS will use in 2014 and beyond to calculate health plan risk scores and risk payment transfers, and includes additional modeling to help understand a population’s morbidity profile.
“With this partnership, we have truly created a dream team of healthcare analytics and leading actuarial and risk modeling,” said Mike Boswood, Truven president and CEO. “This solution brings our health plan customers the information and resources they need to efficiently manage their risk. The health plans that thrive in the post-ACA environment will be those that are most adept at forecasting and optimizing their risk exposures. We are committed to helping them meet these challenges head on.”
The Truven Health and Wakely Consulting combination includes data aggregation, transformation, storage, dispute resolution, and reconciliation with risk modeling and forecasting capabilities to deliver a complete solution to address all aspects of the ACA’s risk adjustment program.
The risk optimization component uses proprietary algorithms to identify patients with the highest likelihood for missing conditions. This can improve patient outcomes and help payers align their risk adjustment with the true risk of the population. Delivering a baseline risk assessment using historical data, the new solution allows health plans to actively determine whether changes in their population will affect future risk scores and risk payment transfers and plan accordingly.
“This partnership combines Wakely’s leading edge risk adjustment and predictive modeling services with best in class data analytics from Truven Health,” said Ross Winkelman, Wakely Consulting director. “The outstanding initial response from carriers has confirmed the strength of our partnership and combined solution.”
To learn more about the Truven Health/Wakely Consulting risk management solution, visit this link. http://www.truvenhealth.com/assets/HP_12902_0813_Leading_Edge_WAKELY_FINAL.pdf.
Truven delivers unbiased information, analytic tools, benchmarks and services to the healthcare industry. Hospitals, government agencies, employers, health plans, clinicians, and pharmaceutical companies have relied on its solutions for over 30 years. Truven employs about 2,000 people worldwide from its headquarters in Ann Arbor and offices in Chicago and Denver.
Wakely Consulting Group is an actuarial and healthcare reform consulting firm providing a broad array of services to the medical and healthcare sectors. For more information visit http://www.wakely.com.