How It Works
Group Involvement
Adjudica's Group Self-Management platform leverages the Internet to disseminate information and build community to enable the actual participants to understand the impact of care decisions and to influence or even control these decisions. The platform allows administrators and plan members to: -
Participate in an online community of group members, a forum for discussion of care options and pricing or anything that might help improve the quality of care.
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Monitor ongoing group plan operations such as expenditures by category, comparison to budget, etc.
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Compare care costs against industry norms.
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Use standard and customizable reporting to identify anomalies and trends, and identify waste or fraud.
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Project likely spending based on year to date trends, impact on individual premium for the next plan period.
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Evaluate proposals for changes to the plan parameters to address budget shortfalls.
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Discuss possible changes to the plan to improve care, control spending or increase or decrease premiums and co-payments.
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Build consensus in support of the changes.
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Project the impact of proposed annual changes to the plan in terms of cost and care.
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Democratically decide to change aspects of their own plan - add or remove covered procedures, set budgets for elective care, increase or decrease premiums or co-payment.
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Securely and privately cast their votes for possible changes to the plan parameters or premiums.
- Allocate a fixed budget provided by the employer or government, with responsibility for making their care fit within the budget or paying for the overruns themselves.