Consortium National Accounts
ValueQuest® ….your Plan’s Sales Advantage
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© 2015 Consortium Health Plans, Inc.
BIOGRAPHY
• Michael Underman
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Senior Vice President and Chief Operating Officer
Consortium Health Plans
Responsible for developing and managing
Consortium’s products and service offerings
• Sid Roberson
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Director, Major and National Accounts
Florida Blue
Leads a team responsible for all new sales opportunities for
commercial accounts with 500+ eligible employees for the
entire state of Florida
• Robert Simes
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•
Senior Director, Sales Business Management
Florida Blue
Leads a team responsible for reporting, data analytics, and
client retention to support major and national accounts
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BIOGRAPHY
• David Toy
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•
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Executive Director, Foundational Products
Consortium Health Plans
Responsible for the development and operation of
foundational products, analytics. and data
• Christopher Lewis
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Executive Director, Platform Services
Consortium Health Plans
Responsible for product architecture and technology strategy
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ValueQuest
Your Plan’s Sales Advantage
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Agenda
1
Consortium Background
2
ValueQuest Overview
3
Florida Blue Success with ValueQuest
4
ValueQuest Data and Analytics
5
ValueQuest Technology
6
ValueQuest Vision
6
Consortium
Background
1
7
Consortium Health Plans
•
Consortium was formed in 1994 to position Blue Cross® Blue Shield® Plans as the
preferred choice for national accounts
•
Consortium supports Plans’ efforts to present a unified, consistent voice to the national
account market through annual refinement of the national account value proposition
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Our vision is to enable Plans’ continued growth in national accounts by providing
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•
market intelligence
•
strong market relationships
•
leading-edge sales tools
Today, Consortium is comprised of 21 member Plans, which represent nearly 92% of Blue
national account enrollment
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ValueQuest
Overview
2
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It’s All About the Conversation...and the Data
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ValueQuest® Objectives
Demonstrate Total Value
Move the Market to PMPM
Call Plans to Action
Enhance Sales Effectiveness
Shift the Conversation to Value
Serve as a Resource for All Plans
ValueQuest Partner Plans
Regence BS
----------------Premera BC
BCBS Northeastern
New York
(Washington)
BCBS
Montana
(HCSC)
Regence
BCBS Oregon
Regence BS Idaho
----------------BC Idaho Health Service
Empire
BCBS
BCBS
Minnesota
Regence
BCBS Utah
Anthem
BCBS
(Colorado)
(California)
BCBS
Kansas
Capital BC
---------------------Highmark
(Pennsylvania)
Wellmark
BCBS Iowa
BCBS
Illinois
(HCSC)
BCBS
Kansas
City
Anthem
BCBS
BCBS
New Mexico
BCBS
Oklahoma
(HCSC)
(HCSC)
Anthem
BCBS
(Indiana)
Anthem
BCBS
BCBS
Texas
(HCSC)
(a Premera Health
Plan)
BCBS
Hawaii
BCBS
Rhode
Island
Anthem
BCBS
(Connecticut)
Horizon BCBS
New Jersey
Highmark
BCBS
Independence
Delaware
BC
(Ohio)
Anthem
BCBS
Highmark
BCBSWV
(West VA)
Anthem
BCBS
(Pennsylvania)
(Virginia)
(Kentucky)
BCBS
North Carolina
BCBS
Tennessee
Arkansas
BCBS
CareFirst
BCBS
(MD, DC, & N.VA)
BCBS
South Carolina
BCBS
BCBS
Mississippi Alabama
BCBS
Alaska
BCBS
Massachusetts
BCBS Western
New York
(Wisconsin)
(Missouri)
BCBS
Arizona
Anthem
BCBS
(Maine)
(New York)
Anthem
BCBS
BCBS
Michigan
BCBS
Nebraska
BCBS
Vermont
BC Northeastern
Pennsylvania Excellus,Inc.
BCBS
Wyoming
(Nevada)
(New Hampshire)
(Anthem,
New York)
Wellmark
BCBS South Dakota
Anthem
BCBS
BS California
----------------Anthem BC
BCBS
North Dakota
Anthem
BCBS
ValueQuest Plan
BCBS
Georgia
Areas using data supplied
by ValueQuest Plans
(Anthem)
BCBS
Louisiana
Florida
Blue
Triple S
Management Corporation
(Puerto Rico)
PMPM Availability in Most Markets
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ValueQuest Sales Placemats
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ValueQuest Sales Briefing
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ValueQuest Sales App
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Florida Blue Success
with ValueQuest
3
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Florida Blue Success with ValueQuest
•
ValueQuest reports are run on our existing groups and are used to support
the Major & National Accounts team with market reporting
•
Success story: We worked with a consultant, and used ValueQuest to win a
7,000 life group with over 11,000 members. This helped the consultant
win agent of record.
•
Utilize ValueQuest analytics and placemats to present PMPM measurement
and our total cost of care value proposition to existing clients and
consultants
•
Success story: ValueQuest analytics were used successfully to renew and
retain an existing group
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ValueQuest
Data and Analytics
4
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ValueQuest Data Sources
Employer Provided Data
Census, Performance
Metrics & Claims
Network Compare®
D & B Employer Data
NDW Historical
Extract
Competitor
Benchmarks
ValueQuest
Projected Network
Discounts
Direct Plans
Extract
Blue Solutions
• Over $7.7 trillion in claims expense
• Covers all 50 states, District of
Columbia and Puerto Rico
Company & Industry
Profiles
Nielsen PRIZM® &
Health Tracks
Bureau of Labor Statistics
Survey of Occupational
Injuries & Illnesses
Census Bureau
Current Population Survey
Dartmouth Atlas
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ValueQuest Data Flow
Blue Cloud
CHP
(2)
BCBSA
National
Data
Warehouse
NDW
Plan
VQ
Workspace
Detail Claims and
(1)
Membership Data
Direct
Plan
VQ
Traceability
& Quality
Review
VQ Core
Application
VQ Sales
Application
Standardized Data
External
data
Sources
Plans
ValueQuest Reports
Benchmarks
Milliman
(facilitates UDS Workgroup
and certifies ValueQuest data)
UDS Workgroup
(funded by CHP to establish
submission standards)
Consulting
Firm
Employer
Analyses
Local
Consultant
Benchmarks
Standardized Data
(1)
(2)
Benefit plan design and program enrollment prioritized for collection
Consortium’s complete infrastructure is managed by Consortium within the Blue Cloud
for maximum collaboration and security
Competing Carriers
Employer
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ValueQuest Market Reports
Market Cost Model
Claims allocation based on member residence preserves geographic patterns of care
Credibility
High = 5,000+ inpatient days
Moderate = 2,000-5,000 inpatient days
Minimal = Under 2,000 inpatient days
47 Standard Cost Categories
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ValueQuest Data Priorities
Benefit Design
Program Enrollment
Prospective Provider Terms
Mercer Competitive Benchmarks
Data Quality
Variance Decompositions
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ValueQuest
Technology
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ValueQuest Technology
Flash Storage Arrays
Virtualized Infrastructure
Columnar DBMS
Improved DB storage
design and maintenance
Flexible and scalable
provisioning of compute assets
6x compression of data
and stunning performance
Business Data Model Design
Accelerated data on-boarding
In-memory Analytics
User driven exploratory
capabilities on large datasets
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ValueQuest
Vision
6
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ValueQuest Vision
Presentations
Solutions
Chris
Sid
Robert
Analyses
Data
David
Chris
Robert
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Questions
?
@
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© 2015 Consortium Health Plans, Inc.