What Claims Data Misses and What It's Costing Self-Funded Plans

When a catastrophic claim hits, most plans are already behind and so are the brokers, TPAs, captives and stop-loss carriers supporting them. This week, Jim Carlson, VP, Head of Business Development, Self-Funded, and Wian Stipp, Lead Machine Learning Research Engineer, of Evidium join The Granite List.Live to discuss what it takes to close the gap between budgeted and actual healthcare spend, as well as why claims, clinical, and pharmacy data so often exist in silos.   Oncology, rare disease and chronic condition progression are among the conditions driving the most financial exposure, and earlier visibility into those cases can change outcomes for the plan, the member and every stakeholder responsible for managing that risk. This conversation will dive into what proactive management of complex members looks like, why claims analysis only tells you what already happened, and what stakeholders gain when they can see what is coming before it hits.