Faced with ever-rising health care and pharmacy costs, the challenges of retaining and attracting employees, and now soaring inflation, business owners, benefits advisors and Today’s HR managers find themselves operating with little margin for error. These challenges create a difficult dynamic: to attract top talent, companies must offer a total rewards program that is demonstrably valuable to employees, and to keep companies in business, they must design and implement these programs in a targeted way. , efficient and effective.
Data analytics provides the necessary insights into benefits performance plan metrics, enabling empowered decision-making to reduce pharmaceutical and medical costs while improving workforce health and well-being. With analytics, companies can not only predict the future health and wellness needs of their workforce, but also develop timely interventions to maximize cost savings and health outcomes.
The population health approach
To truly drive benefits spending forward, companies and their advisors need to take a population health approach that considers cost, impact and experience of care. With data-driven risk stratification, companies can identify and group employees based on common characteristics, including medical history, vital statistics, and potential for developing chronic diseases, then develop programs meaningful health and well-being programs to target the needs of these different groups. Over time, employers will not only save money on healthcare costs, but also benefit from an engaged workforce that is more productive and likely to stay with the organization.
In addition to improving the health of populations within the workforce, analytics help employers and benefits advisors determine how best to allocate their healthcare costs. According to data from Vital Incite, wastage ¾ the use of services that do not improve the health of the individual ¾ accounts for at least 35% of medical plan spending in the United States. A thorough analysis of claims data can reveal sources of waste, as well as identify ways to redirect spending to achieve better health and financial outcomes. The following examples reveal how analysis can identify employee population needs, access current spending and care efficiencies, and identify solutions to improve access to services that ultimately improve health outcomes.
Empowered Decision Making
Many companies are experiencing higher spending on cancer care, even though cancer rates have not increased among their employee population. Common reasons for this increase in spending include an increase in the use of more expensive drugs and late-stage diagnostics. Companies can counter these cost drivers by promoting and encouraging cancer screenings, and providing genetic testing to determine the effectiveness of expensive treatment. In some cases, the tests can direct care towards a treatment plan that is both less expensive and a better, more effective option for the patient.
Many companies are also seeing an increase in spending on mental health services. Since the start of the COVID-19 pandemic, there has been a sharp increase in mental health diagnoses of anxiety and major depression, leading to increased monthly plan expenses, data from Vital Incite shows. Incidence rates increase for all plan participants, with the greatest increases seen in dependents. To support employees and their dependents with emerging mental health needs, companies should analyze their current mental health service offerings to determine if they are reaching the right people, and then assess how best to engage those people. in their care. Identifying and providing solutions not just for children, but that parents can use to learn how to help their children deal with mental health issues, will not only improve results, but will also help improve employee presenteeism.
Get actionable insights
Data analytics provides actionable insights that allow employers and advisors to make informed decisions about the health and wellness programs they offer to employees. Access to comprehensive medical and pharmaceutical claims data can provide insight into care compliance and care orientation, but adding values such as biometric data allows employers to understand whether strategies are improving chronic disease control. Data such as A1c values allow an objective view to determine whether strategies for diabetes, for example, not only engage the right members, but actually improve their control of the disease. With the data in hand, companies can quickly determine whether strategies, such as form expansion, improve risk control and can quickly pivot strategies to reduce plan spend waste.
It is important to remember that there is no one-size-fits-all approach. With population health management, employers can leverage data to develop and target populations most in need, and align health and wellness offerings to improve the care experience through better coordination and communication. By using comprehensive population health data, the employer can make strategic decisions based on facts instead of being influenced by the “shiny new things” being sold. They are able to manage their health plans like they do the rest of their business
A healthy workforce is essential to an organization’s bottom line. Time lost due to employee illness not only hurts productivity and drives up labor costs, but also increases an organization’s expenses for its health plan and prescription drugs. Companies that collect comprehensive data that leverages risk indices and uses analytics to determine which treatments and preventative measures are both necessary and effective will provide the best results and will be able to achieve lasting results. A healthier and engaged workforce is a critical efficiency driver that will set businesses on the path to success.
Mary Delaney, MS PT, CWP, is Managing Partner at Vital Incite, an Alera Group company.