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New Meritain Focuses on Expenses


BizJournals
04/30/2007 

Annemarie Franczyk, Business First

Meritain Health, a provider of services for employers with self-funded health insurance, has developed a new data-driven department to evaluate medical spending to help clients manage costs.

The Cost Management Strategies unit combines Meritain's long-time evaluation capabilities into a service offering greater focus and deeper analysis to tap into a higher level of trending, said Tracie Canby, senior vice president of the Amherst-based company.

"We always had access to data, but we didn't have a department that focused on the data. This offers better structure and better analysis on which to provide recommendations. It's not a one-year strategy but a long-term strategy to better manage costs," Canby said.

The department will analyze current medical spending by Meritain its clients and review and manage high-dollar claims. Meritain then will use this information to decrease the percentage of claims paid at retail cost and determine the best access to provider networks at the group and member levels.

The department also will monitor individual consumer behavior and risk and analyze employee claims and identify trends in health history on both the individual and organizational level. The information will be used to provide long-term services and educate members through the use of clinical-based studies that support and encourage individuals to embrace wellness.

The department will consist of 31 full-time employees, located primarily at Meritain's Amherst office. Three analysts and underwriters are expected to be hired in the next year. Some personnel also will be stationed in the company's Baltimore and Minneapolis offices.

Meritain serves more than 1,400 self-funded clients and more than 1 million members nationally. It employs more than 1,350 and has regional offices in 28 cities.