In the modern world of health care, providers, insurers and patients have access to more health information and statistical data than ever before in human history. This unprecedented volume of information does more than simply help to improve outcomes – it also helps providers and employers take more direct control of their health care plans, allowing for more manageable expenditures and an overall improved standard of care for employees enrolled in a health care program. But what does this mean for your coverage?
The Big Deal with Big Data
“Big data” seems like an abstract term that’s often thrown around in relation to health care information, but it actually refers to the collective set of data available from numerous resources in today’s medical marketplace. As computers have become more and more involved with health care, the ability to gather, collect and share information has exponentially increased.
Doctors, physicians and hospitals have made electronic health records more and more common today. As Employee Benefit Adviser notes, this has allowed for more rapid access and tracking of medical treatment and pharmacy records for employees than was ever before possible. In turn, advancements in computing and machine learning have improved the ability for programs to run comprehensive data analytics and review processes, leading to an increased understanding of risky behaviors and certain precursors that can indicate a potential medical risk or complication possibility.
This has also led to the development of more robust data management and reporting platforms, collecting and analyzing data and presenting in in a more accessible and manageable manner. This benefits self-funded insurers and other plan providers by allowing more comprehensive reporting on the usage of medical and pharmacy benefit programs, providing additional insight for benefits managers on costs and potential areas of opportunity.
Learn more by watching this video posted by Employee Benefit Adviser.
Decisions from Data
In addition to the information gathered from within the health care marketplace, more and more data from external sources can be combined to help identify trends and risks, allowing providers and employers to make more proactive decisions to help improve the health of employees and increase overall wellness of staff.
For example, as Crain’s Detroit Business notes in a recent article, big data can combine information about a specific geography and cross reference it with health care information, identifying potential concerns that should be addressed. For instance, in Detroit, data shows that hypertension rates are higher than elsewhere in Michigan. As a result, this could drive employers to encourage staff to be more proactive about speaking to their physicians about screening or treatment. By being aware of specific risks or regional trends, employers can work to get ahead of more complicated – and expensive – medical demands while helping their workforce to be healthier.
Identifying Group Trends
Data analysis can also explore usage and trends within an employer network, identifying sources of high costs or more generalized trends within your staff’s health coverage plan that can help to mitigate expenses.
By analyzing health plan usage information, data analytics can identify high costs that may come from using physicians, facilities or laboratories that are outside of the plan network or that charge substantially higher rates than comparable service providers in the marketplace. The same may also be true of employees who take high-cost, name-brand pharmaceuticals if generic drugs are available instead. By reviewing this data, employers can encourage plan participants to use lower-cost alternatives, driving down expenses while maintaining or improving health outcomes.
It may also be possible to identify specific health trends within the employee population so that an employer can put together an early intervention program to proactively help reduce plan usage for chronic conditions while encouraging staff wellness. For instance, if a review of plan data reveals a high rate of claims related to back pain or injuries, the employer may put together additional safety training on safe material handling practices to help reduce the incidence of injury or encourage employees to speak with their doctor about their spinal health and ways to strengthen muscles or relieve pain through exercise or physical therapy.
Risk Assessment and Analysis
Risk assessment data can also be used to predict potential future medical expenses based on the health of employees within the plan. This can help plan administrators identify potential costs before they are realized, allowing for more proactive planning in anticipation of an increased need or growth in demand for specific procedures.
In turn, that same data can also be used to gauge the efficacy of proactive programs and incentives within a plan population. For example, if a company offers a discount on premiums to plan members who participate in a voluntary training program or wellness campaign, data analysis can identify whether or not there is a correlating reduction in plan utilization and expenses for related health conditions. This can help tangibly prove the merit of such programs while guiding cost-reduction decision-making.
How Premier Can Help
Big data can drive some big benefits, but it can also seem like a daunting prospect for businesses that aren’t familiar with data analytics. Fortunately, the team at Premier Consulting Associates understands the importance and value of this data and can help your business benefit from big data with our data analytics and reporting tools.
Using PremierLinxSM, Premier’s cutting-edge online management tool, benefit administrators can gain ready access to a full suite of information to review plan usage and outcomes to identify areas of opportunity and improvement. With plan modeling and forecasting, benefit and wellness plan integration, administrative cost tracking and reporting data and much more, employers can better understand current health care costs and predict future potential expenses.
Premier can also assist with proactive health programs, offering trained professionals for individual employee health care counseling, scheduling on-site health clinics or identifying conveniently located programs for wellness screenings, providing online programs and interactive tools for answering employee inquiries about health needs or provider network questions. We can help coordinate benefits for your care program while ensuring that your health coverage meets the needs of your staff, state and federal plan requirements and all HIPAA regulations.
Find out more about data analytics and learn how better understanding of information can improve your health plan costs while leading to better health outcomes for you and your team. Call Premier Consulting Associates today at 716.688.5600 to schedule a consultation.