Neil Godbey is President/CEO of The Godbey Group and Chairman/CEO of Advanced Plan for Health (APH). Neil’s management background includes urgent care and occupational medicine clinics, mobile diagnostics, hospital and nursing home management, start-up managed care organizations, IPAs, HMOs, and hospital strategic mergers, acquisitions, and development.
Furthermore, Neil has negotiated the sale or purchase of over 75 health care companies, including health plans, tertiary care centers, physician group practices, and other health care companies. All in all, it is safe to say that Mr. Godbey is one of the industry’s best versed experts in population health management and data analytics. In fact, his expertise and commitment helped streamline the creation of the most advanced data risk engine available to help improve population health in general.
Drawing from this experience, Mr. Godbey recently published a pair of bylined articles full of health management insights and advice. Below are a few highlights from those articles.
For brokers and consultants to retain self-funded employers as customers, they need to provide them with a clear view of their plan as well as steps to improve performance.
Later, Neil provides a few examples:
Looking at claims data and comparing costs to national benchmarks — adjusted for regional cost variation — can uncover hotspots where an employer may have opportunities to address with better policies that address patients’ needs.
Data trends should be keyed to per-member, per month cost to level-set the field, account for fluctuation in employee levels and the resulting change in the number of covered families. This will help determine if a few high-cost patients skewed one particular year, which in turn influences stop-loss and reinsurance decisions
In another byline published in Employee Benefit News on June 28, 2016, “Views: New Workforce Health Analytics Tools Zero in on Unnecessary Health Costs,” Neil explains that:
5% of an organization’s employees can account for 50% or more of an employer’s healthcare expense.
With the right analytics system, you don’t have to be a data scientist to…improve your health claims outlay….
Benefits managers should leverage [predictive modeling engines] to identify and address common patterns of behavior that significantly increase medical costs.
These might include:
· Creating more granular medication lists. Are employees using non-formulary, compounded or specialty drugs when a cost-saving generic would have the same result? Custom reports catalog unique behaviors such as patients using multiple pharmacies.
· Reining in multiple specialists/multiple PCP scenarios. Some patients may use multiple specialists and multiple primary care docs. Coordinating care under a single PCP can reduce costs.
· Generating next-generation ER utilization reports. Encouraging patients to use urgent care—and avoid the ER copay—can boost a health plan’s bottom line. But you have to know more about ER utilization than you do now to learn when they’re being used inappropriately and predict when it might happen next.
· Improving chronic care. Wellness programs, preventive medicine and case managers all can help at risk populations take better care of themselves and avoid ER visits. But you will have to track the results.
The advice that Mr. Godbey provides in these articles is well-founded, actionable and based on years of experience and success in evidence-based solutions. If you would like to learn more, please visit www.mypoindexter.com or click here to request an Opportunity Assessment, and you will receive advice specific to your unique population and needs.