Built on more than 30 years of transplant experience, The ETS360™ Platform brings predictive intelligence, therapy-specific provider navigation, specialized clinical management, patient support and risk management together in one integrated framework–helping organizations manage complex therapies from early identification through treatment, outcomes and financial management.
WHAT ETS360 MANAGES
HOW ETS360 WORKS
Use the complete ETS360 Platform or select the capabilities that complement your existing clinical, provider and financial infrastructure.
Predict™Predict goes beyond traditional actuarial forecasting. ETS combines population-level modeling with continuous medical, pharmacy and facility claims surveillance to proactively identify members progressing toward advanced therapies.
Potential candidates are clinically validated and risk-stratified, giving organizations visibility into who may need treatment, when, and the potential clinical and financial impact–months before treatment may occur.
Continuously analyze claims to identify and clinically validate members progressing toward advanced therapies–before they become known high-cost cases.
Model population-level exposure across approved and emerging therapies.
Continuously monitor medical, pharmacy and facility claims for changing clinical signals and emerging risk.
Understand which therapies are coming, when they may reach the market and how they could affect the client’s specific population.
Provide ongoing clinical, regulatory and market intelligence as the advanced-therapy landscape evolves.
Navigate™ETS combines therapy-specific Center of Excellence (COE) criteria with access to 180+ leading medical centers nationwide to identify the provider best equipped for each patient and treatment.
As advanced therapies move into broader sites of care, ETS continually evaluates provider capabilities to balance clinical quality, experience, access and patient needs.
Evaluate providers against clinical criteria specific to each therapy–not a one-size-fits-all designation.
Nationwide access to leading centers providing organ and stem cell transplant, cell therapy and gene therapy.
Continuously evaluate new treatment settings as advanced therapies expand beyond traditional academic centers.
Guide patients to the appropriate center and help coordinate access to care.
Care™ETS combines evidence-based medical policy, provider-friendly utilization management, rapid prior authorization, expert physician review and personalized patient support into one coordinated clinical experience.
Multiple policy options allow clients to align coverage with their clinical philosophy and risk tolerance while maintaining evidence-based standards.
Choose from Focused Evidence and Standard Evidence policy approaches to align coverage with the organization’s clinical strategy and risk tolerance.
Fast, reliable and provider-friendly clinical review designed to support appropriate access without unnecessary delays.
Specialized physician expertise for complex treatment decisions and appeals.
Dedicated support with appointments, logistics, travel, manufacturer resources, education and treatment coordination.
Access specialized genetic counseling resources when appropriate.
Administer manufacturer outcomes agreements and ongoing outcomes requirements.
Protect™Protect brings together the intelligence gained through Predict and the clinical and provider strategy managed through Navigate and Care to help organizations determine how best to manage their remaining financial exposure.
ETS combines transparent contracting, cost and claim management, outcomes protection, and access to stop-loss and reinsurance solutions–while supporting organizations that choose to retain risk internally.
Access existing transparent contracts across our group of 180+ Medical centers, designed to address the total episode of care for organ and stem cell transplant, cell therapy and gene therapy.
Manage complex claims, audit charges and identify opportunities to reduce unnecessary cost throughout the episode.
Access and administer available manufacturer outcomes agreements that provide additional financial protection when therapies do not achieve specified outcomes.
Access risk-transfer solutions through ETS partners when transferring some or all of the exposure makes sense.
Use actual population intelligence to determine whether retaining, transferring or combining approaches best fit the organization’s exposure and risk tolerance.
Provide advanced-therapy intelligence, clinical expertise and guidelines to support underwriting and risk decisions.
WHO WE SERVE
Know your actual exposure, guide employees to the highest value care and center, provide expert support and choose the right financial strategy to fit your organization.
Extend your advanced therapy capabilities with predictive intelligence, therapy-specific provider strategies, and specialized clinical management.
See risk earlier, manage the clinical and financial drivers of catastrophic claims, and embed specialized advanced-therapy capabilities into your product.
Help clients understand their actual risk, make better decisions and build the right complex therapy strategy—with the ETS intelligence, expertise and solutions you need.
Every organization’s complex therapy exposure is different. ETS360 helps you understand your actual clinical and financial risk, identify opportunities to improve care and manage costs, and determine which clinical provider and financial strategies make sense for your population.
Start with insight. Build the strategy around it.
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