brekiya°Deep Insight
Tool 04 · Layers 2A + 2B → Value Translation

Payer Value Dossier Assistant

Pick a payer segment; the engine assembles a dossier that leads with the constructed cost data, framed to counter that segment's active bias. What ships is not a slide about biases — it's the sequenced argument, in the order this reviewer is most likely to accept it.

Value Dossier · Medicare Advantage

MA plans with Star-linked ED-utilization exposure

Frame Brekiya as a Star-rating protective play, not a pharmacy line item.

Leading metric
ED-utilization rate per 1,000 attributed members with cluster/refractory migraine
Population
36,960
attributable to this segment
Estimated annual TCOC offset
$17,366,580
Cost model, this segment cut
Evidence order — the sequence matters
  1. 01ER-avoidance cost model — MA subpopulation cut
  2. 02HEDIS/Stars ED-utilization measure exposure
  3. 03Peer-plan precedent (UHC MA, Humana MA)
  4. 04Prior-auth criteria proposal aligned to that same measure
  5. 05Unit economics — last, not first

Standard practice leads with unit economics and rebate context. For this reviewer, that framing walks straight into the budget-silo bias the engine has already detected. Leading with the utilization measure they're actually accountable to displaces the SKU frame before the P&T committee gets to it.

Peer-plan precedent
  • ● UnitedHealthcare MA (Midwest)
  • ● Humana MA (South)
The ask, in one sentence

Preferred access for the cluster / refractory-migraine cohort whose ED-utilization pattern is measurably visible in your Star reporting today.