NavigatorMD, Inc.

The plan modeling tools produce comparative analyses on hypothetical plan strategies using actual claims experience. These tools enable organizations to see immediately, the financial impact of plan changes and “what if scenarios”. Your changes are instantly applied to your actual claims experience and you will not only see the financial impact to the company and employees but you will know who and how employees will be impacted. By simulating plan modifications with real claims experience, these tools are designed to improve wellness, save money and increase efficiency from a personal perspective.

Supported by the rich data analytics & reporting capabilities, the plan-modeling component is a core feature of Design180®. This piece of the system is designed to provide the information necessary to add value to health care planning. Whether you're looking to employ value-based plan design through employee intervention and wellness programs, or simply better track cost driver populations in order to contain cost and retain higher cash flow, the Design180® Plan Modeling tool is where one capitalizes on diligent data analysis.

These tools provide comparative analyses on proposed plan strategies using historical claims data by simulating the effect of user-defined plan modifications. Here you can forecast and model both simple and complex strategy adjustments against actual claims experience in the health plan. These tools interactively support creativity in plan design, producing innovative approaches modeled for higher cost savings, increased cash flow and improved plan efficiency.

• Modify plan stipulations to incentivize target populations
• Craft customized plans around chronic conditions or demographics
• Model consumer-driven health plans based on trending claimant behavior
• Explore plan incentives or disincentives and predict cost and utilization
• Design benefits by drug tiers and/or therapeutic classes in RX plans
• Receiving timely shock claims notification
• Determine categories of disease risks and lifestyle behaviors

Design180® Plan Modeling Tools

• Traditional Plan Design
• Detailed Benefit Design
• Wellness Investment
• HRA & HSA Modeling
• Specific Stop-loss
• Contribution Calculators
• Premium Calculators
• Wellness Investment Calculator
• Co-Pays and Tier Design
• More...