Why brokers must adopt prescriptive analytics for plan designs

Our lives are busier, more complex and face more constraints and uncertainty than ever before. This is especially true for brokers and consultants, who face an ever-growing mountain of data and decisions around client offerings. Fortunately, brokers can now turn to data-enabled tools to save money, spot fraud and deliver better plans. By leveraging data, not just to describe an outcome but to take automated actions, brokers can remain competitive and offer a more personalized approach to benefits plans development.

From descriptive to predictive to prescriptive

A typical data journey begins by looking at past data to describe what happened before evolving to using data to predict what is likely to happen. It then uses this knowledge of the future to prescribe actions that will lead to the best outcomes. Benefits platforms and tools that can combine these techniques over historical and current data are key to unlocking the power of prescriptive analytics for brokers and their clients.

Predictive analytics tell us what is likely to happen next by using statical models and forecast techniques to understand the future. But without taking action and without engaging with prescriptive analytics, the value in having knowledge of the future is lost. The real power comes from using data to influence action and outcomes. Prescriptive analytics focuses on the actions we should take to increase our chances of producing the best outcomes.

A good example of the use of prescriptive analytics in the benefits industry is around prescription drug savings. Prescriptive analytics can leverage data to help spur prescription drug savings by automating communication between doctor, insurance provider, pharmacy and patient. Say a patient has been prescribed a brand name in a high tier of their insurance plan’s list of drugs for a chronic condition. Benefits platforms that use prescriptive analytics can identify an equally effective alternative from a lower tier as an opportunity for savings (to both the patient and payer) and then automate the next steps and create greater ecosystem efficacy. Platforms can automatically reach out to prescribing doctors, confirm substitutions and then switch the prescription at the patient’s pharmacy at their next pick-up — ultimately changing behavior for the better.

Being able to isolate usage, personalize recommendations, provide a better solution and automatically take action can translate into significant savings for a client. Brokers can use these dynamic tools to help their clients make informed decisions about both reoccurring treatment and one-time events, and increase general healthcare literacy.

A diverse workforce calls for modern plan design

The modern workforce spans several generations with shifting needs. Changing expectations among clients means brokers and consultants need to offer more than just traditional one-size-fits-all benefits plans, especially in a world altered by the pandemic.

Consumer behavior has changed, and we can’t operate as if it’s going to return to normal. For example, telehealth’s rise as a viable option for doctors’ visits could be here to stay. Brokers and consultants can use prescriptive analytics in their plan design to capitalize on the shifting attitudes by identifying individuals most likely to leverage emerging technologies and target experiences that encourage good behavior and drive down costs.

Benefits platforms use data and insights from across a broader, more diverse range of employees than those just at a single company, giving brokers a more comprehensive view of market changes and the ability to better meet specific employee needs. Brokers and consultants who use platforms that engage prescriptive analytics set themselves up to be a more dynamic partner to their clients, no matter the industry, company size or employee demographics.

Prescriptive analytics and the ROI of benefits plans

Extensive use of prescriptive analytics not only allows brokers to personalize, package and quote in real-time, it also provides a place where the first real read on ROI is possible. Once an action is taken — once a prescription drug is switched to a more cost-effective one or employees begin leveraging new technology — real dollar amounts and impacts can be measured, and value can be quantified. This quantification of value per action gives brokers and consultants a way to measure outcomes and calculate a tool or approach’s value.

Dashboards that show brokers a breakdown of their customers, their plans and utilization rates, the number of actions taken, and those actions’ value can illuminate the ROI of each tool and approach for each customer. Further, it can help identify tools that may help a different customer address an emerging problem before it explodes into a significant issue. The more automation is made possible through prescriptive analytics, the better support brokers and consultants can proactively offer their clients and the more benefits ROI they can help them realize.

Just the beginning

As the benefits industry’s digital transformation continues and the power of prescriptive analytics expands, brokers and consultants can use these tools to be the dynamic partner companies need to navigate a diverse workforce and better realize their benefits ROI. Adopting benefits platforms that use prescriptive analytics is the first step towards designing modern plans in 2021.

John Thomas is chief data officer at Benefitfocus.