August 21, 2018

The Triple Aim of Benefits Analytics

The average person probably thinks of their benefits as just another form of compensation. When you get a job offer, you look at the salary, bonus structure, health plan coverage and deductibles, and little extras like life insurance, a gym membership, and an employee assistance program. It all adds up to a package that’s meant to attract talented workers like you.

For those of us in the benefits industry, that same package is so much more. It’s a means not only to entice potential employees, but also to improve their health and wellness for the good of everyone on the benefits plan. The Institute of Healthcare Improvement put it best with their Triple Aim framework:

“It is IHI’s belief that new designs must be developed to simultaneously pursue three dimensions, which we call the “Triple Aim”:
Improving the patient experience of care (including quality and satisfaction);
Improving the health of populations; and
Reducing the per capita cost of health care.”

Doctors, carriers, the government, and benefits leaders all face this Triple Aim: to improve care, improve health, and reduce costs. From the employer’s and consultant’s perspectives, the best way to do this is with comprehensive employee benefits that encourage health and wellness. But how? How can an HR team impact the health of their population?

Benefits teams make important decisions every day that affect members' lives. For example, if you add a prior authorization or make other changes to your formulary, your employees will be affected when they pick up and pay for their prescriptions. Or if you change your network providers to favor those who provide value-based care, some folks may lose access to their doctors.

Making decisions like these requires careful consideration and access to real time, high-quality benefits data. But more often than not, employers don’t have the resources, analytics background, or clinical expertise to find insights in their benefits data. That’s where Artemis comes in. A strong, sound data analytics strategy requires a great data partner.

Here’s how an employer or consultant might use a data partner to achieve the Triple Aim of Healthcare:

Cost

  • Calculate employer paid amounts and member paid amounts to track spending
  • Track high cost claimants over time
  • Evaluate cost by service (i.e. inpatient, outpatient, emergency department, etc.)
  • Identify top diagnoses and medications by paid amount

Learn more: Read this case study to see how one employer calculated and reduced wasted spending on one prescription medication.

Quality

  • Measure provider efficiency and value
  • Quantify network utilization (i.e. in-network variance, out-of-network spending)
  • Measure readmission rates
  • Identify members with chronic conditions who are at risk and have gaps in care

Learn more: Find out how one Artemis customer helped steer members towards in-network care.

Health

  • Identify potential risk in your population
  • Find members who have not received age and gender appropriate screenings
  • Measure plan utilization
  • Calculate chronic condition prevalence
  • Justify adding wellness programs

Learn more: Get an inside look at how one employer used data to justify adding a behavioral health wellness program.

Additionally, benefits leaders can go beyond traditional data with the right partner. The Artemis Platform allows users to look at non-traditional feeds like biometrics screenings, absenteeism, eligibility, and more. This allows a more holistic view of your population’s health and wellness, and enables you to get beyond cost to focus on quality and health.

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