Advise Insurance reports significant time savings using Definitive Healthcare

Helping patients and providers navigate the Medicare maze

Currently, 63 million Americans are covered by Medicare. But while millions have enrolled, the process of choosing a plan is not straightforward. When a person becomes Medicare eligible, there are many factors to understand before choosing a plan, including Medicare Parts A-D rules, enrollment timing, plan options, risks, combinations, fees, deductibles, and premiums. It’s enough to make anyone’s head spin. Additionally, not all providers contract with all Medicare plans: This often results in significant consequences for everyone involved. Patients are burdened with finding a new covered physician, transferring their care, and building rapport from scratch. Providers face patient leakage, resulting in significant revenue loss. To prevent this, it’s often in everyone’s best interest for the patient to choose a plan that allows them to continue seeing the physicians they trust.

Advise Insurance is a licensed Medicare agency that seeks to differentiate itself through its commitment to help patients find the best possible plan while ensuring the continuity of patient-doctor relationships. To achieve this goal, Advise partners with health systems and medical groups to create and execute on customized outreach plans to current and prospective Medicare patients. In an increasingly aggressive Medicare marketplace where annual disruptions of care have become common, these efforts can be the difference in helping providers minimize patient attrition, maximize patient attribution, and drive new patient acquisition.

The challenge

Making critical business decisions with a limited view into the provider market

To truly maximize the impact of its unique business model, the Advise team understood the importance of partnering with health systems and provider groups that share their vision for a more consistent relationship between patients and their doctors. Thus, the team quickly began to prioritize the need to develop a deep understanding of the national provider market. Information about providers’ patient populations, payor mixes, operations, affiliations, and physicians became critical to determining future opportunities for partnership.

Operating on its own, Advise worked hard to collect this intelligence. However, because there wasn’t a centralized place to find this information, the teams spent long hours searching through multiple sources to arrive at the necessary conclusions needed to move the business forward.

Advise needed to have a more complete picture of the market and of specific providers they were working with, which would help them to:

1. Prioritize existing leads: The team was focused on their large pipeline of qualified prospects, but they needed a data-driven way to look at the market and prioritize their outreach based on the opportunity size.
2. Book meetings: To leverage their existing partnerships, the team needed to have a deep understanding of the providers and how they operated so that they could have targeted conversations and get a seat at the table with the right decision makers.
3. Tailor their message: Advise Insurance customizes their offerings to provider groups to meet the population needs. Having a deeper understanding of these organizations would further enable them to tailor their pitch.

The team needed a faster and more accurate way to conduct analyses, understand market trends, research potential and existing clients, and uncover needs and opportunities.

The solution

Unlocking the provider landscape for business development and marketing teams

Earlier this year, the team set out to find a data source that would fill these gaps, and after evaluating several options, they chose Definitive Healthcare. The team chose to use PhysicianGroupView to understand the market and specific medical groups. Specifically, they used Definitive Healthcare to:

1. Size the opportunity and prioritize accounts: With Definitive Healthcare data, they gained a deep understanding of the physicians group market, provider populations, payor relationships, and affiliations. Using features like Physician Group Search, they segmented the market based on factors like Medicare charges, number of physicians, and location. They also leveraged payor mix data to prioritize accounts with higher volumes of Medicare charges. With access to significantly more provider intelligence, the team was able to fill in the gaps on their existing leads which allowed them to re-focus on the opportunities with the highest likelihood of success.
2. Prepare for outreach: Before initiating outreach to the providers, Advise used Definitive Healthcare data to gain a deep understanding of the account. Intelligence like the number of physicians, Medicare claims, total Medicare spend, and practice locations allowed them to effectively target and position initial conversations book more meetings with key provider groups.
3. Customize their offerings: Using Definitive Healthcare, Advise considered factors like practices’ physician counts, specialties, locations, affiliations with health systems, and owners to develop a tailored approach for each. With this information, Advise was able to devise strategies to better engage with decision makers and increase their sphere of influence. The data points also enabled them to gain a holistic picture of each account and determine the best acquisition and retention strategies for each. In short, armed with deeper intelligence about the healthcare organization, Advise was able to fine-tune their customization offerings to meet the provider groups’ patient needs.

The impact

Key result: Accessing critical data 94% faster with Definitive Healthcare’s easy-to-use platform

After just four months with Definitive Healthcare, the Advise Insurance team has already realized tremendous value in terms of time savings and quality, depth and breadth of provider intelligence. This time savings, in turn, allowed the team to focus on revenue-generating activities.

Advise Insurance has had an impressive track record to-date. In fact, one Advise provider partner reported achieving 3x their expected Medicare growth targets using Advise’s suite of products and services. As the company looks ahead and grows their health care provider partnerships, Advise has identified several additional uses of Definitive Healthcare data to segment their total addressable market. Leveraging Definitive Healthcare data, the team is optimistic that it will open a new channel for business development.