Navigating Rising Healthcare Costs: How Self-Insured Employers are Improving Affordability and Outcomes

As healthcare costs continue to rise, self-insured employers and their intermediaries must navigate new trends and technologies to manage employee affordability, promote appropriate utilization, and emphasize prevention to improve outcomes, while reducing costs. Let’s explore three important trends that pose challenges to healthcare purchasers: reporting, data visualization, and cohort creation.

Data Visualization

Data is crucial in the healthcare industry, but with numerous data types, sources, and continually changing formats, it can be overwhelming and time-consuming to surface insights. With a strong enterprise data management foundation, it’s possible to create clean and engaging data visualizations that make it easier to absorb information and act on the data. While trying to understand patient trends and health outcomes, benefits managers often have mountains of reports to sift through. With a data visualization tool, you can quickly identify patterns and correlations that may have gone unnoticed before.

Interactive infographic dashboards, bar charts, pie charts, heat maps, and histograms are all useful data visualization tools that can help you interpret data in a more meaningful way. These tools can help you identify patient cohorts and understand disease burden, allowing you to develop targeted utilization management and prevention programs that improve clinical and financial outcomes.

Cohort Generation

One of the most significant healthcare trends in recent years is delayed preventive screenings. For example, patients were more likely to skip routine screening exams during the COVID-19 pandemic, leading to an increase in advanced-stage diagnoses. Employers can stop or reverse this trend by identifying chronic conditions for early detection and prevention and taking control of the prevalence within a population.

By evaluating member benefits and utilization data through process, outcome, patient, and provider levels of aggregation, you can zero in on a cohort that represents a specific clinical or financial opportunity.

Benefits Modeling

Managing employee affordability is a top priority for many employers, and predicting the impact of the current and future benefits plans on clinical and financial performance is becoming increasingly important. With a benefits modeling tool, you can develop plans to measure and manage employee affordability, identify cost-mitigating opportunities, and meet organizational wellness goals.

It can be difficult to balance the needs of your members with the bottom line. A benefits modeling tool can help you balance the impact of different benefit plan designs on member affordability, allowing you to make informed decisions that benefit both your members and your organization.

Generate and Share Insights

To monitor and act on clinical and financial performance indicators, you need to be able to automatically generate and share insights with distinct stakeholders across the enterprise. With an advanced analytics tool, you can do just that. Out-of-the-box and easily customizable dashboards can generate descriptive, predictive, and prescriptive insights that meet the needs of groups and can minimize the reliance on costly actuarial services.

Programming dashboards to automatically refresh and distribute at regular intervals can eliminate the ongoing management and administrative burden of analytics insight sharing. In addition, automatically generating dashboards with a similar look and feel in common file formats (such as PDF, PowerPoint, and Excel) can streamline integration with existing tools and processes and reduce disruption to established workflows. This makes it easier to share insights with stakeholders and make informed decisions that benefit employers and employees alike.