Data Analysis Tool: RPNavigator Employer

Population and Vendor Management

Leveraging our knowledge and experience of health plans and managed care organizations, CAI developed RPNavigator Employer to empower employer groups with the information and solutions they need to make the right health care decisions for their organizations.

RPNavigator, CAI’s data analytical tool, provides an unprecedented combination of power and ease of use, permitting users to gain a better understanding of trends in cost and care, as well as provider performance. By turning valuable raw claims data into actionable information, RPNavigator is an invaluable decision support system and predictive modeling tool, that establishes the foundation for targeted benefit design, vendor selection, clinical analysis, and health care delivery, via an intuitive web based interface

RPNavigator is a robust population and vendor management tool, that provides timely and actionable information, on trends in cost and care:

• For self insured groups, RPNavigator provides independent projections of claim costs 12 months into the future
• For fully insured groups, RPNavigator assesses the validity of rate increases based on 12 month prospective claim cost projections
• Develop ad hoc utilization reports across subsets of the population on a case mix and severity adjusted basis (i.e. identify discretionary use of services by region, business unit, product)
• Project key utilization rates based on population’s disease burden
• Prioritize care management initiatives for a given population based on retrospective and prospective cost drivers
• Measure the impact of care management programs from the perspective of quality, disease progression & cost
• Support the benefit design evaluation, modeling, and decision-making process
• Identify quality of care improvements on a disease specific basis
• Determine the degree to which CM/DM vendors are effectively prioritizing high risk members
• Support the decision-making process around retention of carriers and/or vendors
• Support the assessment of carrier network performance

• Support the process of evaluating aggregate and specific stop loss quotes from reinsurers

RPNavigator, in conjunction with our Client Services Group, is an all-encompassing solution, which provides a more comprehensive approach to improving the quality of health care for employees and their dependents. Our approach is not a typical cookie cutter approach, in that we view each client's needs as unique. Therefore each solution is customized to meet a client's specific requirements. RPNavigator was designed by end-users for end-users and incorporates the input of industry subject matter experts.