Data

Data

Containing health care costs is a concern for employers of any size. With data analytics, self-insured employers have a powerful tool that not only identifies the drivers of cost, but provides valuable insight to better manage your plan’s performance. Simply stated, data analytics, done right, can have a significant impact on your benefit strategy and bottom line. Download our podcast to see how what we do can save your plan money.

Our team of analytic specialists understand the data you want and need to manage your plan’s performance. Using the latest analytic tools, we can transform data into meaningful information. Our reporting is provided monthly, and each quarter we schedule time to review findings and suggest strategies that can assist with cost containment. Our goal is to maximize plan efficiency so that your valuable resources can be used to the maximum benefit of your employees and company.

Big picture planning

There’s no shortage of data available for self-insured plan sponsors, but data is meaningless without a proper analysis. A view of your plan’s overall performance serves as an executive summary. It provides a high-level understanding of costs from one year to the next, the financial health of your plan reserves and claims expenditures. It’s an important starting point in any strategic analysis.

Prescription drug expenses

The onslaught of specialty drugs such as biologics and injectables has likely resulted in double-digit increases in your overall pharmaceutical spend. Their growing availability, coupled with consumer advertising, is driving demand for these products. Left unchecked, a self-insured plan could find itself faced with out-of-balance pharmaceutical spending. Data analytics can reveal which drugs are the costliest, which are most widely prescribed and how medical pharmacy costs compare to commercial pharmacy spend. This insight can help guide needed plan design changes.

High-cost medical claims

Invaluable information can be gleaned from a plan’s medical claims analysis. In particular, employers can identify common health concerns that affect employees. Once pinpointed, employers can build more effective wellness and disease management plans. High-cost claims are inescapable; but analytics can help you determine if the quality of care your employees receive prevents hospital readmittance or future complications.

Network utilization

All medical claims are discounted from their actual billed cost based on the negotiated rate established in your provider network agreement. In-network services will always be less costly than those provided by an out-of-network provider. Your data analytics can segment costs comparing in-network versus out-of-network claims. If out-of-network costs fall outside of acceptable limits, you can implement plan design changes that incent employees to stay in-network.