Businesses are powered by the adept use of data. From distribution methods to market insights, we expect and rely on it to make decisions. Yet, when it comes to optimizing benefits or managing claims cost, the data employers need to make informed decisions is lacking.
Only 16% of employers are using predictive data to identify opportunities for improving health plan performance. But just as you use data to measure effectiveness in other aspects of business, you can leverage insights about your workforce to thrive in the rapidly changing healthcare landscape.
Data points like claims history and health risk level can help direct employees to the right care before they know they need it, while complete medication history allows the opportunity to audit for more cost-effective solutions. Forward-thinking employers are using their workforce data to:
Healthcare needs vary by organization. To provide valuable benefits and improve your bottom line, ensure any health plan solution is tailored to your unique workforce.
Workforce data can help you and your team identify which benefits will attract and retain a competitive workforce, determine custom plan structure and offer additional benefits that drive the best health and financial returns for both you and your employees.
As a self-funded employer, you can use workforce data to build your health plan around which benefits will have the biggest impact. Access to data points like hospital costs and claims frequency, along with emergency room utilization, can fuel network discussions. And during renewals, you can plan ahead with confidence with claim-by-claim plan performance.
Employers can also leverage data to identify additional benefits that drive the highest return. For instance, if your population has a higher prevalence of diabetes or heart disease, you can implement a health coaching program with these specifics in mind. Knowing which health risks impact your workforce can help you and your team determine the best outreach protocols.
Data can also uncover barriers to care. For instance, a pattern of employees avoiding care until it becomes critical—and more expensive—because they lack a primary care doctor. Employers can then use this information to influence communication initiatives or research onsite or near-site clinics.
Employers accept the broad use of network discounts to protect against rising costs, but discounts don’t address the underlying cause of high-cost claims: overinflated healthcare charges.
Prices for procedures, from MRIs to surgeries, can vary up to 1000% in a single market. Since this information isn’t readily available to you or your employees, it’s likely that both parties are overpaying for care. Line item visibility to what has historically driven claims cost, along with clear pricing estimates on future care, gives you the opportunity to better manage future risk.
Employers can make this data usable to employees by implementing a concierge advocacy program. In this approach, advocates use all claims, medical pricing information and predictive data to guide employees towards the highest-quality, lowest cost facilities.
Smart data helps employees receive the right care at the right time and for the right cost.
Predictive algorithms anticipate when employees will need additional care, enabling them to put in place programs that provide employees helpful guidance. Employers who partnered with Healthgram in 2017 avoided over $45 million in unnecessary spending by using data to steer employees to the appropriate level of care.
Just as group-level data informs business decisions, individual health data fuels meaningful, customized care for employees.
With health coaching and onsite medical clinics, employees can receive personalized action plans based on real-time lab data and a complete record of employee and family history. Such data can fuel smarter interventions and promote greater engagement.
Another example: data from wearable devices and smartphone apps can fuel smarter wellness programs. Since the data from wearable devices is unique to each employee’s needs and goals, your program can be too.
Healthgram companies use actionable data to go beyond network discounts while delivering the best quality care to members. See how it can make a difference for your company.