Self-insured employers and their advisors are using healthcare data analytics to help employees lead healthier lives. In an era when public health is in the spotlight, the prevalence of chronic, serious conditions like diabetes, heart disease, and respiratory illness is of great concern to employers and physicians trying to control the spread of COVID-19. Cancer is another top concern, as those affected often have compromised immune systems.
The coronavirus has many employee benefits experts mining their healthcare claims data to see how COVID-19 might affect the members on their benefits plan. They’re looking for condition prevalence, members at risk, age groups, those with pre-existing conditions known to affect the severity of COVID-19, and potential costs for their organizations. This recent whitepaper dives deeper on which conditions to watch for.
Benefits data is the key to exploring all of these avenues and planning for risk mitigation, cost containment, and member health and wellness. Artemis Health anticipates these data needs and creates a number of pre-built reports (we call them “Stories) for our clients. Today, we’ll look in-depth at one Story that has helped clients get a holistic view of their population’s health and risk. It focuses on cancer.
This dashboard, which can be populated with dozens of different chart types showing thousands of metrics, shows how many members in this sample population are being treated for cancers. It gives the benefits team a look at the prevalence within their population, how much the plan is paying, and whether cancer treatment costs are going up or down. In the sample data, the self-insured employer’s cost for treating cancer has risen by 18% since the previous period. This shows the employer may have an opportunity to examine their network, work with health systems on pricing, and look for other avenues to offer value-based care for employees.
Data can also show the prevalence of types of cancer and the costs associated with them.
For this sample population, skin cancer is the most common type being treated. 380 members have claims for skin cancer, and the allowed amount for this condition totals over $650,000. However, the healthcare data also shows that while just 95 members are being treated with maintenance chemotherapy and radiation, the costs associated with this course of treatment are over $4 million. This is valuable information for employers and advisors who will need to budget and plan ahead for next year.
A robust benefits analytics tool will help benefits teams dive deeper and understand more about their population health. In the charts above, you can see we’ve taken a closer look at breast cancer. We’ve calculated the number of members with this condition and totaled costs, but we’ve gone beyond to understand the demographics of the members who may be most at risk.
The female members on this plan in the 50-74 age group total 4,817 people. That’s 12% of the enrolled members on the plan. Additionally, we mined healthcare claims data to see how many of these members are receiving preventive care screenings for breast cancer. In our sample data, just under 50% of members are being screened on the recommended schedule. Benefits managers and consultants may work with their health plans to educate at risk members on the availability and frequency of these screenings.
This same type of data dashboard can be created in minutes for many other types of cancers and other chronic conditions. Benefits teams can explore anything from compliance with screenings to geographic trends to the effectiveness of second opinion services.
With cancers and compromised immune systems being a major risk factor for severe illness from COVID-19, benefits professionals will likely be using healthcare analytics and benefits data to track the health and wellness of their member populations. If you’d like to learn more about how Artemis Health is helping our clients measure their COVID-19 risk, please visit our Resource Center.