What problem are you trying to solve (or question are you trying to address) using real world data? 

Merit Medicine is changing how self-funded employers manage healthcare costs. For these employers, the unpredictable nature of healthcare can be one of their biggest financial burdens. About 1 in 5 employers have faced a claim over $1 million in the last four years, but they simply don’t know when these claims will happen. 

The unpredictability of healthcare costs can significantly impact the financial stability of self-funded employers. Unforeseen medical claims, especially those exceeding $1 million, can severely disrupt budget forecasts and allocations, forcing companies to reallocate resources from other critical areas such as employee development, infrastructure improvement, or innovation. This financial volatility restricts a company’s ability to plan for growth and make long-term investments, ultimately affecting its competitiveness and sustainability in the market. The strain of managing these unexpected costs can also lead to increased premiums or reduced benefits for employees, affecting morale and retention. 

In collaboration with claims and RWD providers, Merit Medicine aims to improve the prediction of high-cost healthcare claims with superior accuracy, providing stability in the unpredictable domain of healthcare spending. 

How does our partnership support you in providing valuable insights?

Merit Medicine leverages extensive datasets, including Veritas’ unique Fact of Death Mortality Index, to enhance predictive analytics and fine tune our advanced analytical tools. The use of Veritas’ Mortality Index enriches our models by allowing researchers to identify deceased patients, to accurately predict disease burden and total cost of care. 

What details can you share about the project design and its outcome? 

Merit Medicine’s application of AI in predictive analytics excels in processing large datasets to identify patient journeys related to severe health issues, blending AI with approaches focused on human experiences. This strategy highlights our dedication to understanding the stories behind the data. The AI models are trained over tens of millions of patient journeys to predict both frequency and magnitude of specific medical diagnoses and/or utilization of high-cost specialty drugs. Analysis of real-world data is based on diagnosis and procedure codes in patient journeys, drug therapies utilized and reference datasets of cost of care for specific chronic, complex and rare diseases. 

What were the next steps or learnings that resulted from the study?

Our goal is to improve healthcare cost forecasting by an order of magnitude. This cooperation helps employers make informed decisions about budgeting, employee benefits, and stop-loss insurance. This is particularly valuable for organizations with smaller risk pools like self-funded employers. Preliminary work indicates Merit Medicine’s insights can help employers find the right balance of cost-efficiency, through reduced stop-loss premiums, and risk-profiling to protect against catastrophic healthcare spending. Employers will be able to predictably budget for healthcare while also ensuring that every employee gets the healthcare they need. 

Learn More

Veritas Data Research was founded by experts in the data analytics industry. Veritas uses cutting-edge technology and efficient workflow design to collect, curate, and distribute foundational reference datasets. Veritas makes critical information accessible to data and analytics teams across the healthcare vertical, as well as customers in the financial and insurance sectors.

For more information about our mortality data or answers to specific questions, reach out to us at Sales@veritasdataresearch.com.

Merit Medicine is an innovative health tech startup revolutionizing employer-sponsored healthcare. Leveraging advanced AI insights, the company specializes in predicting high-cost medical spending and specialty drug utilization in rare, chronic, and complex conditions for self-funded employers. Founded by industry visionary Ali Panjwani in 2022, Merit Medicine empowers benefits leaders with AI-fueled predictions, enabling more effective budgeting and ensuring optimal healthcare for every employee. Merit Medicine is headquartered in Austin, Texas, with remote employees across the United States.

Visit meritmedicine.com to join the waitlist or email contact@meritmedicine.com for more information.