At the core of the Ecom’s service is a robust analytics engine with 10 years of claims experience from more than 100 different PPO’s nationwide. Ecom's network management team works proactively with each PPO to ensure a high level of performance and develops new PPO relationships that can improve utilization and savings for each client. Utilizing patented algorithm’s and actual claims paid history from the client, Ecom examines and prices each claim and compares the result to the historical data. This information, coupled with health plan design and eligibility information produces a comprehensive analysis that identifies incremental savings opportunities and network recommendations.
Most recently, Ecom has developed an analytics methodology that determines the most appropriate primary PPO at the member/subscriber level. Utilizing a member-level analysis is extremely beneficial where members within a group or plan are distributed in multiple states and regional markets. Even within a regional market, utilizing the Ecom Member-Level PPO Selection SM methodology can realize substantial incremental savings over a Geo-Access selection process.
The illustration below compares a Geo-Access selection methodology (industry standard) to an Ecom Market-Level and Ecom Member Level PPO Selection SM. Clients realize significant increase in primary network utilization and average discounts with minimal member disruption.
