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Innovu | Offering Transparency & Accountability | Hugh O’Toole

Hugh O'Toole of Innovu | Offering Transparency & Accountability

Hugh O’Toole


The lack of transparency in healthcare is by far the greatest challenge in the U.S. today. Every day, average American citizens are experiencing the burden of cost in an opaque market. The average healthcare spend per person is more than $12,000, a majority of disposable income. According to 2021 statistics, nearly 65% of personal bankruptcies are caused by medical debt. That is why the Consolidated Appropriations Act (CAA) and new Hospital Transparency laws are so critically important. They will give employees and employers a choice when deciding on a health insurer or healthcare provider that best meets their needs and their budget. As the legislation has brought changes into effect, Innovu has been able to look at the data and identify significant savings opportunities while building a process to help employers fulfill their obligations as fiduciaries.

Health benefits advisors are encouraged to lean into this new legislation and fully embrace the opportunities the transparency changes will bring for their plan sponsor clients. The Innovu platform allows advisors to provide better advice to their clients, finding greater opportunities for savings and supporting a reduction in wasteful spending.

There is also a need for secure data storage, continual support for regulatory compliance and assistance in managing human capital risk. Innovu provides employers and advisors with a combination of the cutting-edge LENS platform and Customer Success experts. This dual-pronged solution means greater opportunity for the advisor team to work with the Innovou team to identificy for their clients, increased savings, decreased healthcare spending waste, and improved employee population health. Once the solution is implemented the system will measure the benefit of the consulting advice and the solution deployed. In addition to these smart data analytics, the Innovu DataVault offers a secure warehouse for data, including compliance documentation.

A Holistic Approach

Innovu CEO, Hugh O’Toole has dedicated his career to aligning the financial wellness of American employees with the positive impact their wellness has on the financial statement of their employers. Leaning on his decades of experience in the benefits industry and his passion for changing the industry for the benefit of employees, Hugh has made population health and wellness a major driver of Innovu company culture. His experience in disrupting the 401k industry has anchored Innovu in its position as a leader in reimagining the health benefits market through data aggregation, data science/analytics and behavioral finance.

Innovu is the leader in data analytics within the health benefits and human capital risk management industry. The company is driving the change in how healthcare benefits are structured, how healthcare dollars are spent, and how employers can effectively manage their human capital risk.

The company is focused on leading the market in five key areas. Establishing a complete data storage solution, real-time access to financial reports, driving significant savings and improving employee population health, fully integrating all data sets to manage human capital risk effectively, and continually supporting regulatory compliance following a client’s obligations as a fiduciary.

 “Our state-of-the-art capabilities, from Member Matching and DataVault, to the CAA toolkit for employers and advisors are the first of their kind within this health benefits space. Innovu continues to work on additional product solutions and insights that will further extend our leadership position within the industry,” says Hugh.

Offering Experienced Consultants

For a more tailored experience of Innovu’s services, advisors and employers are paired with a Director of Partner Analytics (DPA). The DPA is an experienced data professional with benefits knowledge and  a deep understanding of Innovu’s analytics platform, providing additional support for analyses, identifying opportunities, or assisting with evaluating program interventions. Applying methodologies from Innovu’s Analytic Standards of Excellence Committee (ASEC), the DPA identifies opportunities, benchmarks customer trends, and measures the performance of customer program interventions to support the benefits advior and account management teams.

Innovu DPA’s work to identify the savings hidden in healthcare spending, by identifying areas of unnecessary waste and continually reviewing data for trends that signify savings opportunities. According to the JAMANetwork, healthcare spending reached more than 4 trillion dollars in 2020, and nearly 1 trillion dollars of that expenditure was wasteful spending. DPA’s are critical in helping advisors and employers find and eliminate unnecessary spending from their healthcare budget.

In the 2021 calendar year, DPA’s identified more than 70 million dollars in savings for members leveraging the Innovu engagement model. Those identified savings translated into an average of $235, 000 per engagement, or a 7.5x return on their quarterly engagement investment per customer. Innovu DPA’s are continuously monitoring and identifying ROI opportunities, managing and measuring utilization and trends and creating internal efficiencies for employers and their advisors.

Towards the Future

Innovu solutions are consistently the first of their kind in the market. This is due to their close work with advisors and their clientsthroughout the health benefits industry. Their access to millions of data points and the analysis of the LENS platform allows Innovu to continue evolving their solutions for the financial benefit of the users.

“Innovu has been using A.I. in several of our solutions for years. Specifically, A.I. is critical to risk scoring and our, first of its kind, member matching technology,” explains Hugh. “With the new transparency laws going into effect, employers are seeing an influx of data, the likes of which they have never experienced before. Innovu’s Member Matching system can take the disparate silos of human capital data (HRIS, Workers Compensation, Medical, Pharmacy, Retirement) from any system and intelligently match member records in order to give our clients one unified record for each employee and/or covered dependents.” The risk scoring technology also uses the latest in A.I. to identify the cost per member based on various criteria, including age and demographics, enabling employers to manage their human capital risk more effectively.   

Additionally, Innovu has recently integrated with Quantros quality metrics to give even further insights into data, with a methodology to assess cost and quality of care.

As healthcare data becomes more accessible due to new legislation, employers will be able to take advantage of that transparency to reduce cost and waste, optimizing their health plan for the benefit of their employees. As a result, a fiduciary standard that leverages process and data will be created. Innovu is poised to handle those challenges with our next generation of targeted solutions. These solutions will allow advisors and their employer clients to consume data in ways that will save money and lower wasteful spending. Innovu’s comprehensive platform and close relationship with advisors and plan sponsors, means they are able to anticipate anything on the horizon in healthcare data analytics.

Innovu Award

" With the new transparency laws going into effect, employers are seeing an influx of data, the likes of which they have never experienced before. "

Hugh O’Toole


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