Self-insured employers are in an excellent position to provide high-quality health care for their employees at a lower cost. But this requires employers to use all the tools available to them. Cavo Self-Insurance provides these tools.

Here are five ways that Cavo Self-Insurance can help:

• Underwriting accuracy – Self-Insured employers typically do not have a precise insight into the health of their employees. As a result, self-insured employers are at a disadvantage when negotiating with their Stop-Loss carriers who have years of health data averaged over many companies. Cavo Self-Insurance solves this problem. Cavo Self-Insurance will retrieve employees’ medical records and use Precise Word Matching AI to create accurate and complete diagnostic profiles of all requested employees. The result? Precise knowledge of your employees’ health conditions to drive superior Stop-Loss carrier negotiations.

• Payment integrity of claims – Studies show that over 10% of health care claims are bad, meaning that they should not be paid because they are not supported by the medical record. Yet, standard practice is to “Pay and Chase”. In other words, most employers pay all their health care claims and long after the fact chase reimbursement for larger claims that appear out of line. With Cavo Self-Insurance, there is no more “Pay and Chase.” Instead, using Precise Word Matching AI, Cavo Self-Insurance will check medical records for the diagnostic support for all claims before they are paid. This is the surest way to avoid paying bad claims and significantly lower health care costs.

• Predict medical expenses – “Predictions are hard, especially about the future.” Yogi Berra could not be more right. But predicting medical expenses is made easier for self-insurers when they are aided with highly accurate, highly specific clinical data about their employees. This data can then be matched against medical expenses for similar situations. Cavo Self-Insurance will provide this granular clinical data by reviewing medical records with Precise Word Matching AI. In addition, Cavo Self-Insurance will predict diseases, thus giving self-insurers advance warning for likely major expenses in the future.

• Help employees live healthier lives – With the assistance of Cavo Self-Insurance, self-Insurers can be in the prime position to help their employees live healthier lives. Cavo Self-Insurance will retrieve employees’ health records so they can be posted in a health portal for employee access. This provides complete transparency for employees to know about their health care. In addition, Cavo Self-Insurance will use Precise Word Matching AI to read through the medical record and create an accurate and complete clinical profile of every employee. Using this information, Cavo Self-Insurance will create friendly, easy-to-understand reports of employees’ health condition along with predicted diseases and intervention strategies. These health reports can be posted to employees’ health portal along with their medical records.

• Value-Based Care initiatives – One of the most promising ways of lowering health care costs while improving outcomes is deploying Value-Based Care initiatives. Cavo Self-Insurance can help. Upon reviewing employee medical records with Precise Word Matching AI, Cavo Self-Insurance will stratify employees by risk so that self-insured employers can make sure their employees receive the proper care management for their level of risk. In addition, Cavo Self-Insurance can assist is risk-adjusting outcomes and costs to track how providers are achieving successful outcomes at the most appropriate prices.