High-Cost Member Reporting & Prediction

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Profiler is the industry leading platform to quickly identify current and potential high-cost members, analyze their diagnoses and specialty drug usage and predict costs for informed medical risk mitigation.

Actionable Analytics

Profiler quickly identifies members, their diagnoses and projected specialty drug usage responsible for driving annual cost increases.

Inside Profiler

  • 2,500+

    Drug Use Cases Benchmarking Future Spend

  • 8

    Pages of Detailed Reporting per High-Cost Member

  • 0

    Integration Required

Executive Overview

This summary of analyzed claims provides a high-level plan review that highlights potential high-cost members who are approaching their spec deductible.

Business Intelligence

Easily review plan expense categories and quickly identify specific members, providers, specialty drugs and diagnosis that are driving costs.

Member Projections

Dive deep into identified high-cost members to ​compare historical and/or project future member spend based on approved clinical courses of treatment and benchmarked specialty drug cost projections.

Features & Benefits

  • Mitigate Risk

    Anticipate known risk more accurately

  • Dynamic Reporting

    Dashboard reporting on claim costs, specialty drugs and provider spend

  • Benchmarked Costs

    Cost projections across seven drug and diagnosis benchmarks

Knowledge Is Power

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