Affinity Group

Ecosystem Integrated Network Economy  

McKinsey & Company, in its July 21, 2021 article on Ecosystem Businesses, "A Design-Led Approach to Embracing Business Ecosystems," discusses how business members can generate revenue growth through an “Integrated Network Economy.” Their forecast was that 25% of the global economy will grow to ~$70 trillion by 2030.

CaseMed

INTEGRATED NETWORK ECONOMY EXAMPLE: INSURHEALTH MEMBER COLLABORATION.

Member A has a customer but needs a resource from another member. 

Member B has a resource for Member A. Member B’s resource performs the service and sends Member A an invoice, minus the 10% admin fee of the cost for InsurHealth.

Member A invoices the Customer (minus the 10% admin fee for InsurHealth operations) that includes both Member B and Member A’s reduced costs and pays Member B’s invoice.

For a financial example, click here ->.

GuideSmart

INTEGRATED NETWORK ECONOMY EXAMPLE: NURSE CASE MANAGER (NCM) DATA-SIGHTLINE CLAIM TRIAGE. [See Services Page for Workflow Details. INE Details Follow Below.]

There are 4 Personas to the Triage Program:

Claims Adjuster: INE
- Faster Closings
- Reduced Loss Costs
Nurse Case Manager: INE
- NCM Fees, minus the 10% admin fee
- MDA support fee after 1st Month
- Arcadia revenue share after annuity placed.
Medical-Legal (MDA) [Medical Data Analytics]: INE
- New client revenue.
Arcadia Settlements Group [Structured Settlements]: INE
1. New or ongoing client opportunity
2. Early entry into the claim process; increased earnings.

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Affinity Group

Cross-Sector Ecosystem Business Offerings

At a high level, every InsurHealth Member, whether they are Industry Customers, Insurers, Claims Adjusting & Services Companies, Law Firms, National Alliance Partners, Technology Firms, Self-Insured Companies, Healthcare Companies, etc., the InsurHealth Network is an Integrated Partnered and Services Network Economy with an Inter-Dependency on its Members, as depicted below.

The Synergy of the InsurHealth Ecosystem Network Creates a Natural Financial Support System for its Members.

InsurHealth Ecosystem Affinity Group Partner Model and Market Offerings

The Partner Model Illustration below is a Cross-Sector View of the members invited to become InsurHealth Network Owners, Customers, and Service Providers in the Network. We are forecasting 1,700 Network Members in the next 5 years.

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Improving Claims Processing Effectiveness

Data-Sightline Claims Triage^SM Program

The Data-Sightline Claims Triage^SM Program was developed to enable Claims Organizations, Law Firms, Medical Nurse Case Management Companies, and Insureds to better collaborate on the Holistic Coordination of Care for Injured Persons and still achieve their business objectives. With this program, all InsurHealth members can use Data-Sightline to Improve the Holistic Healthcare for the Patients they service with reduced costs, greater accuracy, and opportunities for Integrated Network Economy Revenue Sharing. The picture to the right shows the Core Data-Sightline Team with Claim Adjusters and Nurse Case Managers assisting Injured Patients in collaboration with InsurHealth National Alliance Partners Medical-Legal Solutions for Medical Data Analytics and Arcadia Settlements Group for Financial Consulting on the extension of the injured patient’s claim awards for years beyond typical cash awards.

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InsurHealth Member-to-Member Service Agreements

Integrated Network Economy Agreements

The primary purpose of InsurHealth’s Ecosystem Business Network is to facilitate Affinity Group Member Financial Business Interactions and Services Revenue Transactions Between Members and Revenue Growth.

How do INE Transaction Agreements Work? Member A has a Customer who needs services but needs another member to provide the service. Member A searches the InsurHealth Membership Directory and contacts the Service Member, i.e., Member B. The INE Services Agreement: Member A negotiates the INE Services Agreement with Member B. Member B provides prescribed services and invoices Member A monthly for agreed Time & Expenses. Member A invoices the Customer Semi-Monthly or Monthly for both Members A & B's Professional Fees and Expenses. Both Members A & B report their invoices through InsurHealth’s Gravity Software system. InsurHealth asks for a percentage of the invoices amount to be ceded to InsurHealth for the InsurHealth Network Operations. Results: Both InsurHealth Members expand their services and revenue geo-expansions capabilities at reasonable costs based on the customer’s funding. Intra-Network transactions build strong business relationships and potential mergers and acquisitions. INE Transactions provides financial stability and growth to the InsurHealth Network which builds equity for the Network Member Owners.

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InsurHealth INE Insurance & Healthcare PLANNED Innovations

The cross-industries, cross-states, and national alliance programs, i.e., the Data-Sightline Claims Triage^SM Program, nature of the InsurHealth Network, provide a financial reciprocal feeder system between the members.

Nurse Case Manager Software

GuideSmart^SM Nurse Case Manager Workflow – An Integrative End-To-End SaaS Configurable Software program built on the GuideSmart^SM Platform. Current Status: Operational | Adjuster & Third-Party Access | Expanding for Commercial Use | Equity Options in Investment Page. GuideSmart^SM is jointly owned by CaseMed and DBCLink, LLC.

Claims Adjuster Software 1: Frontend Workflow

GuideSmart^SM Claims Adjuster Workflow Software – An Integrative End-To-End SaaS Configurable Software program built on the GuideSmart^SM Platform. Version 1: Claims Adjuster Frontend Workflow Current Status: Available to Configure Workflow for Commercial Use | Nurse Case Manager & Third-Party Access | Equity Options on Investment Page.

Claims Adjuster Software 2: Frontend & Backend Workflow

GuideSmart^SM Claims Adjuster Workflow Software – An Integrative End-To-End SaaS Configurable Software program built on the GuideSmart^SM Platform. Version 2: Claims Fully Integrated Adjuster Frontend & Backend Workflow CURRENT STATUS: Available to Configure Workflow for Commercial Use | Nurse Case Manager & Third-Party Access | Equity Options in Investment Page.

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InsurHealth Claims Adjusting Services Alliance

“An InsurHealth, Adjunct & Complementary TPA Claims Adjusting Services Alliance (CASA)”

Purpose

As Maintaining Claims Adjuster Staffing Levels can be challenging, InsurHealth is starting up an Adjunct & Complementary TPA Claims Service to be an ally to service claims organizations with Experienced Adjusters in the specialty liability coverage claims, such as Workers' Compensation, Auto Liability, and Medical Malpractice. Initial focus: 1. Rural US Geographies difficult for TPAs and Insurance Claims Organizations to position adjusters. 2. CASA Infusion with broader InsurHealth Coordination of Care and Supporting Claims Services + Data-Sightline Claims Triage^SM Program Services. Led by Melissa Ryan, InsurHealth’s SVP Claims [M.Ryan@InsurHealthAffinityGroup.com] Current Status: 1H2025 Formal Launch

CASA’s Customer Focus

TPAs & P&C Claims – Extension of Adjuster Staffing Needs + InsurHealth Skills MGAs – Support for MGA Specialty Liability Claims + MGA Appointed Agencies Claim Services Self-Insured’s – Working Directly with Risk Managers & Workers' Compensation Defense Counsels

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InsurHealth INE Share

CASA Adjusters become embedded with their customer’s claim staff.
CASA INE becomes a Partnered Revenue & Expense Sharing Model with its Customers.

Opportunity

The InsurHealth Network’s Multi-Layered, Multi-Industries Ecosystem Data Sources, offers an opportunity for Members and Alliance Partners to build Big Data Insurance & Healthcare for real time solutions.

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Market Size

Healthcare Data Analytics Market size was estimated at USD 32.87 Billion in 2024 and is projected to reach USD 173.57 Billion by 2031, growing at a CAGR of 23.12% from 2024 to 2031. Source:

In-Depth Industry Outlook: Healthcare Data Analytics Market Size & Forecast (verifiedmarketresearch.com)

The global insurance analytics market size was valued at USD 12.65 billion in 2023 and is projected to grow from USD 14.50 billion in 2024 to USD 44.77 billion by 2032, exhibiting a CAGR of 15.1% during the forecast period (2024-2032). Source:

Insurance Analytics Market Size | Growth Analysis Report [2032] (fortunebusinessinsights.com)

“InsurHealth Visionary^SM” InsurHealth Network Services Brand

“InsurHealth Visionary^SM” will leverage AI and ML algorithms to interpret patient and services data across the InsurHealth Network members and outside data services to provide insights into:

Descriptive Analyses
Predictive Analyses
Prescriptive Analyses

InsurHealth INE Share

Value Propositions For Members and National Alliance Partners

Revenue Sharing with Members Sharing their data to InsurHealth Visionary^SM
New Revenue Streams for Members, GuideSmart^SM, Alliance Partners, Systems Integrators, Investors, etc.
Current Status: Build 2025 and Continuous Annual Updating and Enhancing.
Equity Options in Investment Page.

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