Employers and Data: The Key to Improving the Experience and Cost of Healthcare

There’s a lot of talk about “big data” changing the game in healthcare, but when it comes to the health and well-being of your workforce, personal health data is the key. You just need to open the door.

When it comes to the accessibility and affordability of healthcare in our country, all eyes have been on Congress. Which way will our elected officials vote, and what will the future hold for Medicaid, Medicare, private exchanges and employer-sponsored plans?

When it comes to making an impact on the experience, quality and cost of healthcare, however, we should turn our eyes to another group, one that holds a lot of power to effect change: Employers.

Not health systems or health plans, but the vast group of employers that provide health insurance for nearly half of the country’s population. As of 2015, 86% of employees at large organizations (>1,000 employees) were enrolled in self-insured health plans.¹

Not only do these employers wield power to bring about change, they also have incentive: Employers depend every day on the health, well-being and productivity of their workforce, and they pay the consequences of employees not getting the care they need. According to the Centers for Disease Control and Prevention (CDC), productivity losses linked to absenteeism from illness or injury cost employers $1,685 per employee annually². At the same time, employers face sky-rocketing growth in healthcare spending – about 6% each year – money they’re not able to invest strategically.

So if employers have power and incentive, what can they do to advance the transformation of healthcare?

claims dataAs a first step, employers can commit to:

  • Putting people, not processes, at the center of health and benefits programs. This means committing to giving employees a completely integrated health and benefits solution, rather than a set of discrete, disconnected tools and applications that are difficult to find, access and use. The experience should be simple, intuitive and compelling.
  • Focusing on improving the health of the entire workforce, not just those identified as high-risk or high-cost today. Accolade found that nearly two-thirds of the high-cost population in any given year is not identified as high-cost the year prior, and a third of that population actually had low projected risk in the prior year.
  • Tending to the unique needs of each person in the employee population, and addressing the whole person, not just their condition. According to an Accolade analysis of claims data over 12 years, the fastest-growing cost concern can’t be attributed to a single condition at all. Instead, it’s “ill-defined claims” involving a collection of illnesses and injuries that are difficult to categorize. That’s one reason why it’s critical to gain insight about the whole person, not just their condition, and use that insight to provide highly personalized healthcare support.

hospitalsThe common denominator of all three of these concepts? Timely access to personal health data. Without it, efforts to improve healthcare through patient-centricity, population health management and whole-person care will falter, which is why healthcare data interoperability has been a major focus of healthcare reform over the past 15 years. Unfortunately, even with government incentives designed to advance health data exchange, the healthcare industry has not made enough progress to make a significant impact.

But where health systems have struggled to make progress, employers might make more headway faster. Employers are better positioned to leverage new technology solutions that aggregate a wide range of data – claims, utilization management, biometrics, lab results, point solution data, as well as insight from interactions – to create a complete personal health profile for each individual. Employers are better positioned to encourage and support people to engage in their own health and well-being beyond the walls of the healthcare system. And employers are better positioned to adopt solutions that help people navigate to the right care at the right time, improving the experience and costs of care.

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¹Employee Benefit Research Institute, July 2016, vol 37, No. 7: lf-Insured Health Plans: Recent Trends by Firm Size, 1996‒2015, p. 2
² CDC Foundation, Worker Illness and Injury Costs US Employers $225 billion annually.