Digging into data reveals where to focus efforts to save money, boost population health
Going beyond periodic reports from providers can produce actionable information that delivers results.
The person who first said knowledge is power may have worked in the benefits industry.
“In my role, it’s vital that we leverage our data to implement solutions,” said Anthony Jarusinski, benefits manager for American Eagle Outfitters. “We are educating and empowering our associates to be better and more-educated consumers of health care. But there are a lot of things in health care that you don’t know you are trying to solve for. You can drill down to know what subset of your population is struggling with various components.”
Going beyond periodic reports from providers can produce actionable information that delivers results.
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“Having real-time data real-time at your fingertips puts you one step ahead of having to wait for quarterly reports and annual utilization reviews,” he said. “By the time you see that data, it’s too late to impact the population.”
Jarusinski was part of a panel discussion on “Digging Into the Data: Case Studies in Controlling Health-Care Costs” as part of the Benefitfocus One Place virtual event on March 3. Digging deeply into data helps him address the ever-changing needs of a fairly young employee population.
We’re always chasing something new, I feel, and the pandemic is an excellent example,” he said. “Before the pandemic, we were chasing an increase in telehealth utilization. Fast forward, and this global pandemic forces people to engage with those solutions. Now the biggest thing is deferred care.
“It’s about being able to pivot quickly and refocus if needed as a benefits leader, because leadership is going to come to you and say, `our new focus is X,’ and right now it is deferred care. Let’s see who has stopped treatment or who has ticking timebomb conditions that may have been ignored in 2020. That are the high-cost claims that may affect an employer in 2021 or 2022.”
Rachel Uhrig, senior financial analyst for Assurance Agency, relies on data to better understand emergency room utilization.
“It’s that low-hanging fruit where if there is abuse with the emergency room, there are different things you can put in place to help combat the abuse – increasing copays, surcharges or communications campaigns,” she said. ”In 2020, because of COVID and people staying at home, we definitely saw a decrease in emergency room utilization overall. In our book of business, utilization decreased 10 percent from 2019 to 2020. A lot of that is due to the mindset shift from in-person to online. We are realizing we can get the same services and get the same things accomplished online that we did in person. Telemedicine is huge now.”
Tamara Warn, a clinical analytics consultant and self-described “data geek” for USI Insurance Services, turned to data to determine why a client experienced a large increase in mental health-care costs from the previous year.
“We’re not talking about 10 percent – we’re talking about a 70 percent to 80 percent increase in mental health costs,” she said. “I looked into their mental health-care costs and over the years, it did get higher. Then I broke it down by diagnosis and found that 80 percent of their costs was due to autism and that 70 percent of their cost was from one provider. I’m so glad that we have the tools available to drill down and see what exactly was causing the increase and implement a better strategy for the client.”
In-depth analysis helps American Eagle focus on doing what is best for its employees, not necessarily following the latest trends.
“American Eagle is not implementing program X because it’s the latest and greatest buzzword in the insurance industry,” Jarusinski said. “Behavioral health will affect our population for years to come, but for years it was a buzzword. We don’t go after the latest industry buzz. We know exactly what’s going on in our respective buildings and implement plans for that. It’s not just throwing a blind dart. I think our population is appreciative of that.”
They also appreciate employee contributions remaining steady for two straight years.
“When you look at a challenging year like 2020, that resonates with your population,” he said. “We have been on this journey that it’s a shared responsibility. We can do all that we can to help our associates become more-educated, better consumers of health care. But need to get engagement, which we are getting. That reduces our claim costs, and we are able to pass along flat or nominal increases.“
When digging into data helps hold the line on costs while contributing to better employee health, it’s win-win for everyone.
“My role and the role of any benefits leader is simplifying the complex,” Jarusinski said “Know your data, know your population and implement a program to mitigate risks. The proudest part of my job is when an employee says, `Anthony, this program saved my life’ or `I wouldn’t be here today without this program.’ That’s why I, as a benefits person, wake up every morning.”
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