Problems faced by TPAs
Third Party Administrators are in a competitive market with limited ability to differentiate. Self-insured employers are setting goals for TPAs to reduce costs, increase return from health programs, improve communication with employees, and use all the employers’ health data to improve outcomes.
Main challenges that TPAs face these days are:
- Unable to identify future high risk members using all the data to prioritize care, disease and case management.
- Unable to provide actionable reports and insights to the clients showing ROI of all the programs and initiatives.
- Unable to engage employees in relevant programs to derive value and bend the cost curve while lowering risk.
How can we help?
Simply put, zakipoint Health will help you in the following ways:
- zConnect will tell you exactly who to target – zConnect brings all the data in one place including medical, Rx, HRA, pre-certification etc. The pain-point that the TPA is solving can be analyzed using all these data which will then tell them exactly who should they target based on the predictive analysis.
- Latest technology at your disposal – zConnect makes it easy to engage at memer level. Reach out through our campaign manager and communicate via text or email with your members. The coaches and nurses can chat with members and answer their queries within seconds. This helps TPAs create a niche in the market for themselves as being readily available to the members to get their doubts cleared.
- Customized reporting – zConnect doensn’t believe in one size fits all when it comes to healthcare. From the member analytics tool to the outreach campaigns and stop-loss reporting, we customize so that you only see what you want.
- Outreach at its best – Not just text messaging, zConnect also has an app specficially for members who can utilize it to understand their healthcare costs and overall manage their healthcare in one place. From PCP visit reminders to plan usage notifications, the zConnect app will help the members manage their healthcare better.
- Connect with all your stakeholders through our platform – zConnect’s dynamic dashboard will help you with reports such as stop-loss reporting. Engage your brokers and stop-loss carriers in one place.
Medical analytics tool
What is it? – It provides a 360-degree view of an individual member
How can you use it? – It will enable the nurses or the medical management team to gather a holistic picture of a member in terms of overall medical and rx utilization patterns, clinical condition, care gaps, biometrics or any other program participation data.
What are the benefits? – Using our user-friendly tool, nurses are able to do a quick search in the control center and go right in to the member summary page thus saving time. Seeing the member data in one place, you can save time and be efficient. There is no need for manual reporting. The medical management team can reach out the member and answer their queries instantly while making notes and saving them in one place for future reference.
What is it? – A comprehensive stop-loss report
How can you use it? – Stop loss carriers and vendors can use the list of certain number of specific deductibles for stop loss.
What are the benefits? – A concise report will show the stop-loss carrier all the spec limits in one place. The need for manual reporting is minizmxed. This dynamic dashboard will engage the brokers and the employers by providing the necessary stop-loss information in one place.
Member outreach dashboard
What is it? – A dasboard that enables member outreach via text, email and secure message
How can you use it? – Use the dashboard to create outreach campaigns such as diabetes management outreach, PCP visit due etc. and monitor the engagement using our advanced reporting tool.
What are the benefits? – zConnect gives you the ability to reach out to a cohort with a generic or customzied campaign. You can choose from a library of 100 templates to create multiple campaigns. A robust dashboard will ensure you are not spamming the same member in a short period of time. The library/contet will motivate change across key risks, cost drivers and use cases.
Mobile app for members
What is it? – A comprehensive healthcare app for members
How can you use it? – App to inform about the following: member-level health status, plan usage, nearby providers, notifications on
preventative care visits and gaps in care, and recommendations to save money.
What are the benefits? – zConnect app is specific for members who can use it in various ways to manage their healthcare costs. The app helps affect member behavior through reminders, interventions, and information which results in improved health outcomes (gaps in care are closed), and helps members choose lower cost options (mail order, PCP vs ER, lower cost providers).