Cutting costs without negatively affecting employees can be a big challenge. This case study can help. Read on to learn:
One of the biggest challenges in the benefits industry is how to incentivize member behavior. In this case study, we’ll look at how one Artemis Health customer used data to find and tackle out of network spending.
This customer wanted to better understand their dialysis spending to help members seek lower-cost, in-network treatment.
How do you positively impact spending without negatively impacting your member population? This is where Artemis comes in. Our proprietary data models and easy-to-use analytics tool helped this customer find savings on an expensive procedure while still offering quality care to members.
Tip: Out-of-network claims are “low hanging fruit” for benefits analysis.These costs are often preventable, and smart benefits teams will focus both on network steerage and ensuring their network is meeting members’ needs.
The Artemis Platform makes complex analyses a snap. We compared costs, member risk scores, utilization, and more with just a few clicks.
Our team broke down claims to the provider level, allowing the customer greater insight into the causes of their out-of-network costs.
The customer noticed a clear trend in their benefits data: both year-over-year costs and the number of out-of-network claims are rising. Armed with this information, the benefits team will audit network coverage and communicate through the carrier with members to help them choose lower-cost in-network dialysis services.