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As a result of health reform, the role of the broker and health benefits consultant has changed. Employers are demanding more strategic guidance and rigorous data analysis to help them better manage their health plan amid skyrocketing costs. Reform pushes brokers and consultants to provide self-funded employer clients with a clear view of their plan and actionable steps for improving plan performance. Data analysis, backed by common-sense human interactions to take action on the steps identified for plan performance, can give you the edge. Employers who haven’t invested in claims data analysis can make quick, significant gains by addressing population health management’s low-hanging fruit – prescriptions and encouraging appropriate care venues. Some examples include:

  • More granular medication lists
  • Multiple specialists, multiple PCPs
  • Next-generation ER utilization reports
  • Improving care of chronic disease patients

Download the complimentary eBook, “The New Broker: Self-Insured Employers’ Population Health Management Partner to see how APH positions brokers and employers to manage rising health costs like no other partner can. Available here.  

Every employee population has its own needs and opportunities for streamlining costs. But you can’t address needs and opportunities until you analyze the claims data and compare it to benchmarks from an all-payer claims database.

Detailed and ongoing data analysis is the key to dash-boarding where hidden healthcare costs reside. 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 costs. Data trends should be keyed to per-member, per month (PMPM) cost to level-set the field, account for fluctuation in employee levels and changing number of covered families. This will help determine if a few high-cost patients skewed one particular year and influence stop-loss and reinsurance decisions.

With the newest user-friendly analytics tools keyed to population health management objectives, services that used to take weeks and cost tens of thousands of dollars are significantly less expensive, simpler and quicker. Using different views of these data sets can help plans “zoom in” on cost centers they hitherto didn’t know existed within a few minutes, and can address them by working with both patients and negotiating with healthcare providers to improve both the health of the patient and reduce the cost of the services they receive – and copays, too. 

As APH’s exclusive predictive modeling software engine, Poindexter creates a multi-point analysis, factoring in individual health status, behaviors and non-clinical attributes, that cover a wide range of triggers and benchmarks to identify opportunities and risks in your population. The data drills down to multiple levels of detail.

To discover what unsurpassable drill-down looks like, request a demo or free opportunity assessment here.

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