Product Development KEY STEPS

Key to our pricing and product development activities are WSP’s healthcare data analysis and model building capabilities.  Our actuaries and data warehousing partners have tremendous experience in analysis of healthcare data supporting model building, healthcare cost and utilization analysis, claims distribution development for model building, demographic and clinical analysis of utilization, and statistical validation of models and observed patterns in healthcare data.  Each of these areas contributes to a complete, client-specific understanding of anticipated healthcare claim cost and utilization.

Once the framework for a new product or initiative is established, the focus is on product pricing to assure both accuracy and competitiveness going forward.  With its healthcare benefit pricing models and access to large, detailed national databases of healthcare claims, WSP carries out stochastic and deterministic pricing for health and related insurance products.  This often includes development of value based pricing strategies for risk management, risk modeling, reinsurance and care management strategies.

New products may be developed for a variety of reasons, whether to differentiate an organization or to meet competitive requirements.  WSP’s involvement with this stage of product development often includes introduction of new technologies to enhance existing products, development of product illustrations, and training of actuaries, underwriters and sales staff on new products or technical innovations.

WSP participates in or facilitates the planning process, conducts competitor and environmental analyses, analyzes organization strengths and weaknesses, designs and implements survey instruments to support the planning process, and analyzes and evaluates the strategic plan.  WSP is also experienced in developing business plans for insurance entities, including pro forma financial projections.

Strategic Planning and Business Plan Development

Product Development and Innovation

Product Pricing

Healthcare Data Analysis and Model Building

Quantifying the impact of care management strategies is one of the biggest challenges faced by managed care organizations.  Cost management strategies are easier to evaluate by simply repricing, given access to a sufficient healthcare claims database.  However, the impact of care management programs such as disease management and specialized catastrophic care management programs are much more difficult to evaluate.  This is because they are almost always implemented on a wide-spread basis without regard to measurement.  There is no “control group”.  This leads to what we refer to as the classic “path not taken” problem.

 

WSP works with care management companies and their clients to construct believable scenarios for the “path not taken” which will result in meaningful analysis of the true cost impact of the management strategies.  This scenario construction often involves the analysis of large data sets.  WSP will direct these efforts with organizations specializing in the management and manipulation of large healthcare data sets.  The end result will be a defendable value analysis that can be readily adapted into product pricing and cost projections.

 

 

Evaluation of Care Management Strategies