Employer groups and payers are increasingly using online tools to control healthcare costs and improve their employee and member health status.
“Employers are placing a significant burden on their health plan partners to provide the necessary tools and direction so employers can evaluate specific relevant trends and take action where needed,” said Kevin O’Mara, vice president of Health Data Management Solutions (HDMS).
These tools are also helping to evaluate such programs as wellness and disease management. “In recent years, these programs have been widely adopted by large and medium-sized employers, but how best to communicate, incentivize and measure performance of the programs are still evolving issues,” said Mary Henderson, HDMS’ president.
The tools are aimed at helping employers quickly and accurately model changes driven by healthcare reform.
Aon Consulting leverages HDMS’ tool on behalf of its middle-market clients with 5,000 lives or fewer. The data is enabling employer groups to shift from negotiating rates with payers to controlling the overall management of benefits, including health and productivity management. “This is fundamentally a game-changer,” said Scott Rabin, senior vice president.
Ultimately, Aon Consulting is striving to engage its clients and their vendors to improve the health status of its employees and members, he said.
BlueCross BlueShield of Kansas City, or Blue KC, deployed HDMS’ online tool nearly three years ago to its employer groups with 100-plus members, said Darren Taylor, vice president of the information access division. By comparing their costs and utilization to benchmark data, employer groups can then customize their benefits plans.
Blue KC is determining what other data, such as workers comp, to include, he said. “Healthcare dollars are only a third of the cost,” he said. “When you add productivity data with claims and health risk assessments, you can tell a more complete story.”
Blue Cross Blue Shield of Michigan deployed HDMS’ online tools in 2006 to give its employer groups reporting and analytic capabilities.
Healthcare costs – between 8 percent and 12 percent annually – represent the biggest cost escalation for companies, said Gary Gavin, vice president of Blue Cross Blue Shield of Michigan.
HDMS’ tool, deployed in 2006, compares a group’s data to BCBS of Michigan’s benchmark data, representing its entire book of business. By comparing their data to other groups, payers can adjust their benefits plans to be more competitive, he said.
