Decoding Health Care Data: How Claims Analytics Saves Employees and Businesses Money

 Keenan Blog

Decoding Health Care Data: How Claims Analytics Saves Employees and Businesses Money

January 10, 2024

Imagine having a treasure map leading to millions buried within a mountain of seemingly random rocks. That's what health claims data is for businesses offering health insurance: a vast, untapped resource waiting to be unlocked for better decisions, healthier employees, and cost savings.

Mountains of data are generated daily about how your employees use healthcare benefits. If properly analyzed, this information holds the key to understanding where your healthcare dollars are going and how to make them work harder.

From Raw Data to Smart Decisions:

In its raw form, claims data is nothing but a confusing jumble of numbers. But we can transform that jumble into valuable insights through the power of data analytics. Think of it like turning rocks into shiny gold nuggets!

This isn't just about cost-cutting. Health benefits are a significant investment in your employees' well-being, and data analytics helps you ensure you're getting the most bang for your buck. It answers questions like:

  • Are we spending too much on out-of-network care?
  • Is there a trend of rising hospital admissions?
  • Are our wellness programs keeping employees healthy?
  • Can we design incentives that encourage preventive care?

Different Layers, Different Answers:

Data analytics takes us on a journey of discovery within the data, peeling back layers like an onion to reach the core truth. Here's how:

  • Descriptive: This first layer paints a basic picture. We see how much was spent, who used the plan, and which providers were chosen.
  • Diagnostic: Now we dig deeper. Why are costs rising? Is there a specific condition driving hospital visits? This layer identifies the "why" behind the numbers.
  • Predictive: We can forecast future medical costs and utilization based on past trends and employee demographics. This helps us budget wisely and prepare for potential issues.
  • Prescriptive: Finally, we combine all the knowledge to find solutions. Can we adjust plan design? Should we partner with different providers? This layer uses the data to chart a course for improvement.

Unlocking the Value of Benefits:

Data analytics isn't just about saving money; it's about building a healthier, happier workforce. By understanding how employees use health care, we can design benefits that truly serve their needs. This not only improves morale and productivity, but also leads to lower long-term costs.

So, ditch the cost-shifting strategies and embrace the power of data. Asking the right questions, unlocking the insights hidden in claims data, and making informed decisions – that's the roadmap to truly bending the cost curve and creating a winning health benefits program for both employees and businesses.

Remember: Your health claims data isn't just a pile of numbers; it's a treasure map waiting to be explored. Keenan’s solutions are built on leveraging the power of data to help our clients implement and maintain high-value, sustainable employee benefits programs. If you want to see how we can help you, contact your Keenan representative or email info@keenan.com to connect with us.