Mark A. Caron, FACHE, CHCIO, CEO

Human resource executives and benefit managers are acutely aware of the power of advanced analytics and data to improve the quality and cost of employee healthcare.

Geneia’s survey in collaboration with the National Alliance of Healthcare Purchaser Coalitions (National Alliance) found near universal agreement. The most salient findings are:

  • 97 percent of HR practitioners agree “now more than ever it’s essential to have tools to effectively evaluate data and make informed decisions.”
  • 95 percent of respondents are interested in accessing the information that advanced analytics can provide
  • 90 percent of respondents said near-real-time data is imperative to realizing costs savings

The survey also revealed the existence of an information gap between the current users of data and analytics and non-users. Most respondents (87 percent) said they are familiar with advanced analytics, but current users have a stronger understanding of how this kind of tool helps aggregate data, control spending, and manage health and wellness programs.

At Geneia, we know data and analytics can be intimidating to the non-user. That’s why we have worked to simplify and accelerate the process for extracting the most value, and are in a position to share best practices for getting started.

1. Start with your health plan. More and more, health plans are improving their employer reporting, moving from monthly and quarterly paper reporting to employer portals with timely, actionable information. The savviest of health insurers have analytics tools that allow employers to compare performance across plans.

One of the health plans Geneia works with now provides all employers with access to dashboards of readily consumable information, including:

  • Hospitalizations: Number of employees currently in the hospital, the number discharged in the past 10 days and the percentage readmitted.
  • Low engagers: Number of employees who have not been seen by a primary care physician in the past 12 months.
  • High utilizers: Number of high-cost employees.
  • Costs: Current year per member per month (PMPM) costs with variance and peer comparison as well as the same information allocated to inpatient hospital, outpatient hospital, professional and pharmacy buckets.

To help employers engage with their health plans about data and analytics, Geneia created a list of eight critical questions to ask, including:

  • How often is the data updated and how frequently do your employer clients access the information?
  • Is your reporting self-service, readily understood and actionable by existing human resources staff, and comprised of drill-down capabilities for further exploration?

To view the full list of questions, visit: https://www.geneia.com/blog/2016/december/eight-questions-to-ask-your-health-plan-about-employer-reporting.

Another resource is employer coalitions like the Lehigh Valley Business Coalition on Healthcare. LVBCH has embarked on an initiative to pool its members’ data and work collaboratively to address systemic issues such as diabetes care and outcomes.

2. Prioritize. In our experience, when employers first see their health data, there is a tendency to want to boil the ocean. Almost always there is ‘low hanging fruit.’ The most successful employers pick one or two priorities in the first year, such as out-of-network utilization, pre-diabetics and activating low engagers in their health.

3. Collaborate with your company’s health plan(s). Even if your company’s health plan is unable to provide the kind of timely, actionable information described above, they know employers have much more ready access to employees and typically are enthusiastic about partnering to improve the rates of recommended preventive screenings and encourage in-network utilization. They also may be able to recommend benefit changes to encourage employee behavior such as seeing high-quality, lower-cost providers.

4. Look ahead. Some say the Holy Grail is to identify the cohorts of employees who are likely to become sick in the next 12 to 24 months and engage them to prevent illness. Increasingly predictive analytical models are able to determine who the rising-risk employees are, and then health plans can direct tailored care management resources to these employees.

It’s easier than you think to get started with analytics, and it’s important too.

With employer health costs on track to increase about five percent this year and likely at least that much in 2019 and 2020, data and analytics offers human resource leaders an effective way to mitigate cost increases.

The Geneia/National Alliance survey found many of your colleagues already know the power of analytics, as 83 percent of them said advanced analytics is the only way to lower costs and improve financial results through better understanding of how employees use healthcare services, who the high-risk employees are and how to intervene effectively.