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HOW IT WORKS

What working with us actually looks like

From first integration to monthly reviews, here's how we turn your data into lower spend and healthier people.
Vital Incite team members collaborating and laughing in the office

5 simple steps, on repeat

Integrate

We bring your claims, clinical, pharmacy, and vendor data into one validated source.

Review

We sit down with you and your team to turn our findings into decisions that make a real difference.

Expert support

Our strategy team takes the lead on identifying and driving improved outcomes.

Monitor

Every month, we read your data through every lens and flag what's impacting your spend.

Vital Oversight

When the data surfaces a problem, you get a recommendation, along with a team to act on it.
PHASE 1

Onboarding and integration

We do the heavy lifting to get things off the ground

Getting started takes about 8 to 17 weeks, but don't worry, most of that work is ours, not yours.

During this phase, we collect, connect, and validate every data source that touches your health plan, then we work with the vendor to support them in cleaning up their files until it's complete and reliable enough to make decisions on. This foundational work means that by the time your first analysis lands, the data behind it is already clean.

What we handle

Collecting and integrating your claims, clinical, pharmacy, HR, and vendor data — down to EAP and absence management — into one continuously monitored source.

What we check

The field's most rigorous data validation, run on every source, so nothing you act on later is coming from incorrect numbers.

What we need from you

Very little — just a few authorizations or NDAs where data sources require them, and your time in the strategy conversations that follow.

CLAIMS
CLINICAL
PHARMACY
HR
VENDOR
Validation of every source
One source
Continuously monitored
PHASE 2

Review

Regular check-ins with your embedded data team

As soon as your data is complete and accurate, your strategy team runs a deep analysis and provides you with insight on what's working and what opportunities exist. From that point on, they are by your side to provide support for any questions you have and respond to any significant changes identified. Their expertise and objective information is in the room when the decisions about your plan get made, and we're with you every step of the way.

Every review led by your senior strategist and advisor

MONTHLY

Priority areas

Review of active cases and the issues most impacting spend

QUARTERLY

Vendor reviews

Performance reviews, with you and your vendor partners

POST YEAR-END

Year in review

Watch the full year revealed

PRE-RENEWAL & RENEWAL

Renewal strategy

Set before the numbers lock

PHASE 3

Expert support

Our expert team looks for ways to drive improved outcomes

Between reviews, your strategy team keeps working. They're assigned to your plan, they know your population, and they spend their days looking for ways to improve outcomes. Every opportunity they surface comes with a recommendation and the reasoning behind it, so your team can take action, instead of trying to figure out what it all means.

Our team looks for:

What's driving cost

We immediately identify and offer strategies to get in front of new plan cost drivers.

Emerging risk

Risk is a key cost driver, so identifying health risk and effectively controlling it is the other side of the coin needed to get ahead of trend.

Voids in care delivery

Objective information illustrates what your people need to really care for themselves. Our strategists bring in their expertise to help remove barriers, provide efficient access, and support strategies that drive success.

PHASE 4

Continuous monitoring

Predictive data analytics, working in the background

Most plans find out what went wrong at renewal — a year too late to do anything about it. Our team supports a proactive approach instead. When we learn something from another plan, we examine the opportunity for all plans. Our predictive healthcare analytics identifies opportunities to redirect care, circumvent erroneously paid claims, or warn of emerging risk. With Vital Alerts, we monitor 100% of your claims every month and flag what's moving before it becomes a number you can't change.

What we watch for:

Better-value alternatives

Wherever a member could be on a more effective or lower-cost therapy than the one they're on today

Emerging high-cost conditions

Diagnoses trending toward serious spend, caught early enough to change the trajectory

Payments out of range

Any charges that fall outside expected limits and may be worth recovering

PHASE 5

Vital Oversight

When additional support is needed, our team is there for you

When the data surfaces something worth acting on, you're not left to figure out what to do with it on your own. You're fully backed by our team to guide you and help you turn the data into lower spend and healthier employees.

When opportunities surface, we provide guidance

TIER 1  |  INCLUDED IN VITAL INCITE

Strategic intervention

Led by your strategy team and advisor

Each alert becomes a clear recommendation: what's happening, what it's worth, and what to do about it.

TIER 2  |  VITAL OVERSIGHT ADD-ON

Active intervention

Our medical team engages on the care itself

When a case calls for direct clinical involvement, we step in to change the outcome and the cost.

We rely on Vital Incite as a key partner to drive decisions for our mutual clients based on data, not intuition.

With their resources, platform and knowledgeable team, we can collaboratively measure the success of programs and partnerships to truly see where to have clients invest their time and resources most effectively.
Jeff LeClaire

Managing Partner, Alera Wisconsin

You'll see opportunities fast.
Savings follow.

A realistic timeline to reducing healthcare costs for employers

We can't tell you savings will start on day one, but here's what we can tell you: Within about 2 weeks of your data being validated (following phase 1), you'll have real insights you can act on. Measurable financial impact typically follows over the first 6 to 12 months.

Timeline: weeks 1 to 12, onboarding and integration; data validated; about 2 weeks later, first insights you can act on; 6 to 12 months, measurable impact on spend; ongoing, compounding as the cycle repeats.

Frequently asked questions

You'll have insights you can act on within about 2 weeks of your data being validated, and measurable financial impact typically follows over the first 6 to 12 months. It takes 8 to 17 weeks to make sure your data is complete and accurate during phase 1, a critical step to arm you with a clear, trustworthy, objective view of all components of your health plan.

Very little. We handle the data integration end to end, so your involvement is limited to a few authorizations or NDAs where data sources require them. The real fun comes when your team learns more about your plan and you start adjusting your strategy to create success.

Think of our team as the constant feedback you might get from a driving app — we identify speed bumps and potential hazards long before you hit them. We help redirect and keep things smooth so you can achieve your ultimate goals.

Yes. We leverage the most trusted, internationally recognized predictive analytics risk indexing from Johns Hopkins. Those values are imperative and influence most strategies.

Population Health Consulting focuses on the overall health, risk, and performance of a population, helping employers turn data into strategy and action. Vital Oversight focuses on individual cases, using advanced technology and clinical expertise to identify opportunities to improve care, address potential payment integrity concerns, and reduce healthcare waste.

Ready to act on your data?

Now you know how Vital Incite works. The next step is a conversation about what your data shows, where the opportunities are, and what acting on them could be worth for your organization.