Are you using your healthcare provider’s aggregate data to your advantage? Two speakers at a recent national seminar say you should treat those reports like your new best friend.
Marcia A. Wright, senior director of medical affairs with Pfizer Inc., was a keynote speaker at the International Foundation of Employee Benefit Plans’ annual conference in November. She said employers should track the cost and volume of their workers’ most common health conditions and the pharmaceuticals and procedures they use. Then use that data to guide your strategy.
You can get your aggregate claims data from you plan’s insurer, broker, third-party administrator or benefits administration partner. Since the information is not revealed per individual, is not against HIPAA regulations to study the data.
One of the best indicators of future trends, according to another of the seminar speakers, is pharmacy data. William J. Einhorn, an administrator with Teamsters, said the medications your employees purchase today are a good indicator of the onset of conditions and diseases that may become extremely costly down the road.
Einhorn said to look for information such as: What services are being used? What services are not? What benefits or services should be covered but are not?
The 2007 book, BeneFIT Design: Seven Steps to Value-Based Health Benefit Decisions, lists the following information that should be “mined” for nuggets of gold:
Enrollee Information
• Who is enrolled and using your plan?
• Age, gender, member contributions, etc.
Direct Costs
• Utilization
• Paid claims
• Contributions and administrative costs
• Claims distributions
Indirect Costs
• Absenteeism (includes lost time because of disability)
• Presenteeism (includes return to work with limitations)
• Impacts on quality of life
Businessolver’s single source platform, Benefitsolver, delivers real-time analytics that allow you to closely monitor enrollments by benefits class to determine if your communication strategy is effective. Learn more about what enrollee and other information you can analyze within the Benefitsolver system by contacting your Businessolver representative.
