Self-insured employers spend an average of $13,600 on healthcare per employee, per year. At least 30% of that spending ends up wasted. Why?
- Overuse of emergency room
- Poorly managed chronic conditions
- Mismanagement of high-cost claimants
- Increased spend on Rx benefits
- Low member engagement
- Inefficient service utilization
Cutting-edge data analytics suites use predictive analytics and integrated solution pathways to clarify employers’ healthcare spend and drive action to reduce it.
BREAKING DOWN THE PROCESS
1. IDENTIFY
Employers need to understand their healthcare spend and recognize opportunities for savings. Client specific predictive analysis is the best way to address key cost-drivers and prospective risk. In other words, this step tells the employer what is going on “under the hood” and presents the opportunity to diagnose the problem. With diverse mixes of employee populations, there are a multitude of issues that an employer could encounter. Data analytics will also help the employer prioritize opportunities for savings based on current spend, population health and prevalence.
2. ACT
Now that you have access to all of this data, what do you actually do with the information? Many employers get to this step and realize that there is no clear direction. They’re unsure of how to apply analytics or what actions to take. There’s also the possibility that the employer doesn’t have a platform for member outreach and is unable to engage or deliver personalized information to drive action. Employers need a data analytics system that also facilitates customized outreach to its employees.
To improve benefit utilization and encourage better personal care and wellness among employees, employers must provide population-specific action plans and solutions. With the correct data analytics suite, gaps in care can be identified. For example, employer A may have 350 members (employees and dependents) diagnosed with diabetes. However, 192 of those members have not received an A1C test in the past 12 months. These members are grouped through unique identifiers (while always remaining HIPAA compliant) and the employer can now customize communication to these members on the benefits of an annual A1C test. This capability facilitates engagement through personalized push notifications to empower members to improve their health and benefit usage.
Simply identifying the health risks is not enough. Direct action is the best way to improve the health of your employees and reduce costs.
Cutting-edge data analytics suites use predictive analytics and integrated solution pathways to clarify employers’ healthcare spend and drive action to reduce it.
3. TRACK
Employers need the ability to visualize the impact of actions on spend and member health. With data analytics tools, employers can set goals on the individual and aggregate levels. Employee engagement, progress and wellness challenges can be tracked.
The employer can also track and optimize service utilization for urgent care to avoid ER use, prompt medication adherence, implement low-cost pharmacy solutions, promote existing services like telemedicine, and communicate with the entire member population.
With this data, employers can now understand what changes are most necessary and how to best achieve them. With a specific challenge identified, unique solutions can be implemented, including benefit plan design changes, such as a $0 copay for low cost/high quality providers.
A true understanding of your population’s health paired with the ability to affect real change is a most powerful tool – one that is necessary in today’s medical landscape.
WHO SELF FUNDS?
- Employees with 50+ Employees
- 60% of US Companies Self Fund
- Self Funded Plans Have 20% Fixed Cost
- Up to 80% Potential Savings
- 100 Million Individuals Covered in the US Under a Self Insured Plan
Think it might be time to consider self-funding your organization’s benefits…
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John Turco
Senior Vice President | Employee Benefits
John Turco is a Partner and Senior Vice President in Employee Benefits at RogersGray by day – and professional comedian by night. At RogersGray, John serves as a lead advisor for employee benefit and human resources related topics like healthcare reform, HR business planning and alternative funding methods.
In his spare time when he’s not spending time with his wife and their two children, John performs at various charitable events, comedy shows and corporate events. You can connect with John on LinkedIn or by email.