Take Control Of Your
Health Plan Spend

Health Cost IQ exists to help self-insured
entities save money within their health plans.

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Smarter Health Plan
Spending

A SaaS platform that helps you effectively analyze
past spending, accurately predict future costs, and
make strategic changes to save your company money.

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Empowering Savings,
Eliminating Waste

Customers reclaim an average of 20-30% annually in health costs,
resulting in hundreds of thousands to millions of dollars in
reduced health plan spend.

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Analyze

Armed with HCIQ’s data insights, customers can identify problematic utilization patterns and uncover inefficiencies, waste, fraud, and abuse within their health plans.

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Predict

This deep dive into data analytics allows customers to forecast future healthcare costs, estimate trends, and predict potentially high-use, high-cost members.

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Save 

HCIQ customers reclaim hundreds of thousands of dollars for midsize entities and tens of millions of dollars for larger enterprises in reduced health plan spending.

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Book A Demo

 (800) 526-3540

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Proactively Pinpoint Waste in Your Health Plan

Reclaim 20-30% of Your Annual Spend

The cornerstone of effective health plan management is a data-driven approach. Armed with the tools and data insights available through HCIQ, organizations can engage in evidence-based decision-making. Our customers are equipped to:

  • Quickly identify utilization patterns and cost trends
  • Accurately intervene to curb hefty, unnecessary health plan spending
  • Quantify inefficiencies, wasteful spending, potential fraud, abuse, and unnecessary costs
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What We Do

Gain Access to Critical Insights
In These Areas

Medical-&-Rx

Medical & Rx 

Uncover high-cost medical and Rx claims, encounters, and utilization patterns to lower health plan costs.
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Risk

Track past, current, and future member and group risk status and quickly identify emerging health trends.
Payment-Integrity

Payment Integrity

Accurately identify claims payment irregularities, waste, fraud, abuse, and costly formulary inefficiencies.
HCIQ Tools Can Provide Answers

Frequently Asked Customer Questions

Leveraging a suite of advanced algorithms, the dashboards within our Opportunity Discovery Module deliver insights derived from a comprehensive analysis of medical and pharmacy data. This deep dive uncovers systemic inefficiencies, wasteful spending, and avoidable costs that exist within most health plans. Clients are empowered to identify and quantify, in precise dollar amounts, overpayments and opportunities for savings. Armed with these insights, concrete actions can be taken to mitigate costs and proactively prevent recurrence.

Employing sophisticated risk stratification, profiling, and predictive modeling processes, our Risk Module monitors and measures the health status of members or groups and emerging health trends within the population. The Johns Hopkins ACG® System and the DataIQ® suite of proprietary algorithms chronologically and geographically highlight associated costs to prepare for future expenses proactively.

Our Health Plan Module contains a suite of administrative dashboards and reports designed to enhance the efficiency and cost-effectiveness of health plan management. Included are mapping applications that empower strategic decision-making across critical areas such as stop/loss coverage, plan renewals, population trends, and more.

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Testimonials

Customer Praise

Quotes From Clients and End-users

THIS IS AWESOME!!! I just can’t contain my excitement!! I think our carriers will be thrilled as well. THANKS, David and crew, for going above and beyond my expectations!!

Jean Ann Cloud

Asst. Benefit Plan Administrator – Operations

Holly and David are EXCELLENT at peeling apart the data and helping isolate and teach me where to obtain the info I need, AND are developing new dashboards and reports patiently with me and my availability. Whenever I do ask a question, I receive a response the same or next day!

Brian Lewis

VP of Operations & Client Services

Thank you for always being on the spot! I couldn’t do my job without you! Super happy that I can rely on you and the programs you’ve incorporated for us. It’s been a life saver!!

Ellen Lewis

Benefit Plan Administrator

Customer Wins

Organizations like yours are already reaping the benefits of our data-driven approach.

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$2.5M 

Identified medical claims overpayment by a PEO
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$1.5M

Saved stop-loss coverage by an education consortium
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$300K 

Reduced admin costs by a medical management company
Latest Articles

What’s New 

blog
Sep 18 2024
  • by Jude Odu
  • 0 Comments

AI-Driven Health Plan Innovation

Improving Member Outcomes and Cost Management for Self-Insured ...

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blog
Aug 29 2024
  • by David Goldstone
  • 0 Comments

Curbing Non-Emergent ER Visits

A Cost-Conscious Approach Through Employee Education Did you know ...

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blog
Jul 24 2024
  • by Jude Odu
  • 0 Comments

Unlocking the Power of Data

Making Payer Data Work for the Self-Insured Ecosystem Thanks to ...

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