Plan sponsors, and the benefit advisors supporting them, have sought for years to find the means to best strategize benefits design and offerings for plan participants. To be successful, they have needed to think critically along with using traditional, actuarial, and underwriting tools, as well as basic algorithms to determine both value and knowable outcomes. These values and outcomes are categorized by administrative excellence, regulatory compliance, clinical outcomes, financial effectiveness, member and provider experience, and the addressing of underlying inequities in the health care system. 

For years, success in the design, deployment, and execution of effective programs and solutions has been limited by quality of available data, the sophistication of the data warehouses in which the data is contained, as well as the ability of the owners of the data to discern, provide, and enact actionable outcomes. This has resulted in a limited ability to define and measure success of various programs and solutions; both plan sponsors and members have been ill-served by these limitations. This has also resulted in plan sponsors, and payers creating complicated ecosystems that are based upon the hope that an unproven series of point solutions will solve for a given set of supposed or apparent clinical and financial issues. This in turn has led to member and provider confusion and abrasion, resulting from a lack of integration and a movement away from "whole health." 

Plan sponsors, and those advising them, have historically been fundamentally dependent on the payers for the quality and breadth of the data, as well as the accompanying analytics and reporting needed to determine necessary proof points. The payer community operates almost entirely from aged and/or antiquated administrative, adjudication, and clinical platforms. The resulting analytics are often based upon flawed, inaccurate data. While most payers have made significant investments around interoperability (the bi-directional flow of content and data between them and providers) and data warehousing, there remains significant room for improvement.