A 2016 report from the American Health Policy Institute found that a staggering 20 percent of total employer health care spending—$2 billion across the 35 major employers surveyed—is wasteful. That is to say there are preventive care solutions, medication adherence gaps, and a variety of other hiccups and inefficiencies that account for a significant amount of spending in the American health care system.
All the variables involved put employers in a tough position to reduce that sum. When inefficiency is so varied and so systemic, it can be that much harder to root up and weed out.
What’s the best way to tackle the 20 percent? Borrow a page from Silicon Valley’s playbook: use big data.
Drowning in data
A core challenge of employee population health management is one of scale. The wide view is mired in numbers and can make it easy to miss the trends and miss opportunities to help improve population health overall.
“The struggle has been … ‘What does this mean?’” says Target’s former Director, Healthcare Strategy Bonnie Toussaint of the sheer amount of data she used to be accountable for in leadership meetings. “What’s the summary? What’s the Cliff’s Notes? I don’t need 10 pages of Excel spreadsheets.”
There’s both science and art in separating the signals from the noise to distill the bullet points that inform executive summaries. And there are a number of health data aggregation tools available to purchase.
There’s also Health Plan Manager, which provides data aggregation at no additional cost to UnitedHealthcare’s national customers. It’s an easy-to-navigate tool that provides a platform for analyzing utilization, costs and population health. It also supplies benchmarks against which employers can measure performance based on industry norms and prior periods.
An asset in the boardroom
The trends and insights Health Plan Manager surfaces aren’t just the bullet points of an executive summary, they become the inputs to tangible, actionable plans that may improve employee health. They also define measurable goals that plans can be measured against or optimized by.
If a benefits manager is also a data whiz, he or she can use the tool to access a company’s entire wealth of data and tease out the insights that drive reports. For everyone else, there are analysts like Craig Kurtzweil.
“Some of these employers rely on us to bake the bread, so to speak,” says Kurtzweil. “We still do what we do and still analyze our data to come to them with solutions and ideas.”
Kurtzweil is National Vice President, Data Analytics and Innovation at UnitedHealthcare, and he leads a team that consults with clients regularly to digest the data Health Plan Manager provides and draw insights from them.
“A lot of what we do within Health Plan Manager, especially with larger populations, is break apart their aggregate averages. Underneath each one of those averages, you start to see sub-populations that are doing better or worse than others,” says Kurtzweil. “Once you start to break that apart, you start to find some nuances, some nuggets of opportunity. Whether it’s market specific, employees versus spouses, different demographics, we can segment the population to help find the root cause of a trend.”
A $900,000 opportunity
To see Health Plan Manager in action, consider a large employer that, using this tool, noticed among its entire population a surge in out-of-network doctor visits in Florida. With some additional digging, they pinpointed the root cause: a spike in back treatments among Latino employees in the area.
To counter the trend, culturally relevant employee messaging that emphasized network alternatives for back care was delivered to the Florida target. This amounted to a $900,000 difference for this employer.*
The applicability of this tool is as varied as are medical conditions. Notice an increase in ER visits? Educate employees about urgent care options, the differences in copays and out-of-pocket expenses and the value of telemedicine. See a concentration of childbirth complications? Connect with female employees about the importance of prenatal programs. Rising per member per month costs? Check to see where you are at with UnitedHealth Premium®. Certain orthopedic specialists for example, may have lower complication rates, fewer re-dos and 26 percent lower average costs. Educating members about these doctors makes good financial sense and may improve employee outcomes.
Get help making sense of your health data or get up and running with Health Plan Manager today by emailing Cheryl Lippert at Cheryl_Lippert@UHC.com
* All savings opportunities represent historical performance, are case-specific, and are not a guarantee of future savings.
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