Faced with continuously rising healthcare and pharmacy costs, challenges in retaining and attracting employees, and now a surge in inflation, today’s business owners, benefit consultants and HR executives find themselves 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 going, they must design and implement these programs in a targeted, efficient and effective way.
Data analytics provides the needed insight into benefits performance plan metrics, enabling powerful decision making to reduce pharmacy and medical costs while improving staff health and wellbeing. Through analytics, companies can not only predict the future health and wellness needs of their workforce, but also develop timely interventions to maximize savings and health outcomes.
The public health approach
To really move the needle on benefit spending, companies and their advisors need to take a public health approach that considers costs, impact and experience of care. Data-driven risk stratification allows companies to identify and group employees based on common characteristics, including medical history, vital statistics and the potential for developing chronic conditions, then develop meaningful health and wellness programs to meet the needs of these diverse groups. 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 the population within the workforce, analytics help employers and benefit counselors determine how best to allocate their health care spending. According to data from Vital Incite, wastage – using services that do not promote the health of the individual – accounts for at least 35% of US medical care expenditures. An in-depth dive into claims data can reveal the sources of waste, as well as identify ways to refocus spending to achieve better health and financial outcomes. The following examples show how analytics can identify the needs of the workforce, access current spending and care effectiveness, and pinpoint solutions to improve access to services that ultimately improve health outcomes.
empowered decision making
Many companies face higher cancer care expenditures, although the number of employees among their employees has not increased. Common reasons for this increase in spending are an increase in the use of more expensive drugs and late-stage diagnoses. Companies can counteract these cost factors by promoting and incentivising cancer screening and by offering genetic testing to determine the effectiveness of the expensive treatment. In some cases, testing can focus care on 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 care. Since the start of the COVID-19 pandemic, there has been a surge in the diagnosis of anxiety and major depression in mental health, leading to an increase in monthly subscription spending, data from Vital Incite shows. Incidence rates are rising for all plan members, with the highest increases in dependents. To support employees and their dependents with emerging mental health needs, companies must analyze their current mental health offerings to determine if they are reaching the right individuals and then assess how best to involve them in their care . Identifying and providing solutions not just for children, but which parents can use to learn how to support their children in coping with mental health issues will not only improve outcomes but also help improve employee presenteeism.
Get useful information
Data analytics provides actionable information so employers and advisors can make informed decisions about the health and wellness programs they offer employees. Access to comprehensive data on medical and pharmacy claims can provide insights into care compliance and direction of care, but adding values such as biometrics can help employers understand whether strategies are improving management of chronic conditions. Data such as A1c values enable an objective picture to determine whether strategies for, say, diabetes not only target the right members, but actually improve their disease control. With data in hand, companies can quickly determine whether strategies, such as formula expansion, improve risk management and quickly realign strategies to reduce wasted plan spend.
It is important to remember that there is no one-size-fits-all approach. Through population health management, employers can use data to develop and target the population in greatest need, and align health and wellness offerings to improve the experience of care through increased coordination and communication. Using comprehensive population health data, the employer can make strategic decisions based on facts rather than being influenced by the “new shiny objects” being sold. They can run 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 the amount an organization spends on its health plan and prescription medications. Companies that collect comprehensive data that leverages risk indexes and analyzes to determine which treatments and preventive measures are both necessary and effective will deliver the best results and achieve sustainable outcomes. A healthier, engaged workforce is a critical effectiveness factor that will put companies on the path to success.
Mary Delaney, MS PT, CWP, is a managing partner at Vital Incite, an Alera Group company.