Big data is playing an increasingly larger role in benefits strategic planning and if a broker, health plan and employer work together, the opportunities for using such data to lower costs and increase well-being can be realized.
Although medical claims and health status data have been collected for years, the technology and analytics now exist to be able to analyze these large datasets, says Paul Fronstin, senior research associate at the Employee Benefit Research Institute. You can now really dig down deep to look for people with specific diseases, he says. When you have millions of people in the database, you could have thousands with diabetes and you can look at things across a number of plans.
Pick a disease, what impact does [drug use] have on medication adherence? Are people who are less adherent more likely to wind up in a hospital; the emergency room with complications?, he says. What is the relative cost of providing drugs to hospitalization?
Data mining can allow advisers to create risk probability charts to help clients keep their health costs down year-over-year, says Jim Campbell, CEO of Gaithersburg, Md.-based brokerage Axim Global Strategies Group.
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A successful broker takes all of the information and puts it into a useable model that is specific for an employers population, which is different than the information a carrier will produce, Campbell explains.
In one of Axis models, they use lifestyle management tools that also contain data, he adds. That data becomes who that person is and how [one can] work to offset the claims.
It helps make a broker more proactive for their clients. Brokers are reactive, they only handle things when there is an issue. They dont do anything on proactive side, he says. Data you collect year-over-year or trend, you need to use that data to better help the person every single day.
Long-term planning
Analyzing the data has helped employers with their long-term planning, such as deciding to provide certain drugs free of charge. If the co-pay is an impediment to taking the drug and the impediment causes people to wind up in the hospital with complications, maybe we should do the reverse and give these away for free when it is a high-value service, Fronstin says.
To help determine if that is the best case, employers need to look to their brokers for assistance, adds Shari Davidson, vice president at large employer coalition the National Business Group on Health. She says that two-thirds of NBGHs member firms use a third-party data warehouse to help them analyze their data. Most of the remaining third have some form of data analytics capacity.
As a former VP of benefits at a large employer herself, Davidson says that the best brokers and consultants are partners.
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At her previous job, Davidson says her broker looked through 20 sets of data and the aggregate information to identify things that were high problems or actionable. The broker then helped Davidson make dashboards to send to that companys locations on items that the locations needed to focus on.
She [the broker] was an extension of my benefits team who had an expertise in looking at [data], Davidson says. I always try to make sure the broker and health plan are a partner. That they are providing most actionable data [and] they help you identify products that could help or where you should put your effort to have an impact.
