AMS re-release of CensusRater, an automated risk module that uses census data to project small group risk.
AMS Re-releases CensusRater: A Statistically Validated Approach to Small Group Underwriting
MyHealthGuide Source: Advanced Medical Strategies (AMS), 9/26/2023
Lynnfield, MA – Advanced Medical Strategies (AMS), a leading healthcare affordability software company providing clinical insights and financial analysis for complex medical claims, announced the re-release of CensusRater, an automated risk module that uses census data to project small group risk.
For years, underwriters and brokers have struggled to accurately evaluate small groups moving from fully insured to self-funded coverage. Without access to credible claims data and an absence of adequate tools available in the market, the self-funded industry has had to rely on outdated and inefficient methods of risk assessment like medical questionnaires.
CensusRater, which was originally released in 2021, solves for this gap in data by leveraging AMS’ entire proprietary claims database of 212M claimants and trillions of claims dollars across every major commercial network. CensusRater analyzes the age, gender, and location of every member on the census and compares it to other members within the claims database that match these demographic features. The tool then measures the statistical likelihood of that member, based on their demographic segment, to breach various claims dollar thresholds over the next twelve months. CensusRater then provides a statistical projection of group claims below and above a dynamic specific deductible.
Over the last two years, CensusRater has endured rigorous testing and validation from one of the largest independent actuarial firms in the industry. Simultaneously, AMS has identified key MGU, Carrier, and Broker partners to utilize CensusRater and provide feedback for product enhancements. Today, AMS is thrilled rerelease this industry-changing product.
“CensusRater is revolutionizing the way that small group underwriters and brokers evaluate small group risk. Instead of relying solely on inflated manual rates, health questionnaires, and risk scores, CensusRater provides an actual projection of claims at the aggregate and specific level. These projections are derived from statistical analysis based on hundreds of millions of members and trillions of claims dollars, which produces consistent and accurate results,” states Peter Borans, Co-Founder & CEO at AMS. “CensusRater rounds out our full suite of products that can support underwriters and brokers evaluate any group, regardless of size or the amount of claims experience available.”
AMS’ AI-powered Predict Platform is the industry’s first cloud-based enterprise software to integrate custom modules that target price transparency, clinical insights, and financial benchmarks. Focused solely on analyzing the most expensive and complex claims and accompanying financial impact, AMS provides Health Plans, MGUs, TPAs, Brokers and Stop-Loss Carriers with enterprise benefits to help improve medical spend and positively impact healthcare affordability. We believe that “Knowledge is Power”. Contact Stephanie Belschner, Senior Vice President Client Relations, at email@example.com and visit mdstrat.com