Five Reasons Healthcare and Benefits Data is Essential in 2020

At Artemis Health, we believe healthcare and benefits data is essential all the time. After all, we operate in medical claims data, Rx claims data, wellness program data, and more every day. But we can all agree that 2020 has been a unique year, not just for public health or politics, but for the benefits industry as a whole. 

Self-insured employers, benefits managers, data analysts, benefits brokers, and benefits consultants have all seen their priorities shift, their workforces change, and their budgets shrink in 2020. This year, HR leaders have navigated coverage for a brand new disease, helped workers transition to remote work, and pioneered new policies on workplace protective equipment and health protocols. 

Now more than ever, benefits data is an essential tool in the tool belts of benefits professionals. In this article, we’ll look at five reasons healthcare and benefits data is a crucial resource for self-insured employers and benefits advisors. 

Reason 1: Tracking COVID-19 Risk 

2020 will long be remembered as the year the novel coronavirus swept over the world. While the disease was first identified in Wuhan, China in 2019 (hence the name COVID-19, which stands for Coronavirus disease 19), employers and public health officials took action in 2020 to slow the spread. 

Many Artemis Health clients sent office workers home and supported managers and IT personnel as they helped employees set up workstations, borrow equipment, and learn how to use video conferencing tools. These strategies weren’t just to follow local and state restrictions on gatherings; they were explicitly to protect employees and “flatten the curve” within their organizations. We are enormously proud of our clients who navigated a new normal with remote work, as well as those who kept their doors open as essential businesses and services. 

Artemis helped our clients make these crucial decisions with healthcare and benefits data. We prepared a COVID-19 Risk Assessment dashboard, accessible to all clients, that showed several key areas of risk: 

• Number of members in high risk age bands 
• Members with diabetes, heart disease, cancer, and other high risk conditions 
• Geographic spread within a member population compared to CDC mapping

This data helped employers plan for risks to their population, make data-driven decisions about returning to the office, and predict costs for COVID-19 coverage. COVID-19 data truly was an essential tool for benefits professionals in 2020. 

Reason 2: Finding Out-Of-Network Benefits Spending 

In-network vs. out-of-network is the difference between predictable and unpredictable benefits costs for a self-insured organization. With COVID-19 causing some very real confusion around public vs. private healthcare points of care, medical necessity of preventive testing, and other issues, employee benefits teams are doubling down on data to help them track out-of-network claims. 

A great data partnership can help employers and advisors look closely at a number of areas of out-of-network spending:

• Number of claims
• Total cost of out-of-network claims 
• Claims by geography and health plan
• Providers with many out-of-network claims 
  

While these metrics are essential for understanding the cost of out-of-network claims, it’s also crucial for employee benefit teams to use this data for filling gaps in care. For example, employers might use a dashboard like this to see which providers are driving out-of-network spending. 

You can see that one of our top 10 out-of-network doctors is a psychiatrist. This suggests that members in her area are not aware of or able to access mental healthcare within the network. This is a gap that a benefits team will want to address. 

Reason 3: Monitoring Employee Wellness with Benefits Data

Are your employee wellness programs worthwhile? Are your members using them, and are they leading to better health? Do you have any way of knowing (besides the program’s own reporting)? 

In a recent case study, we looked at the mental health of Portico Benefit Services’ members and helped them evaluate their mental wellness options. They found that the cost of behavioral health conditions was increasing year over year, and discovered increases in several conditions: 

• 6.7% increase in mood disorders 
• 6.3% increase in anxiety disorders 
• 8.9% increase for adjustment disorders 
• 5.6% increase for other mental health diagnoses 
  

Portico decided to evaluate and work with two new vendors to help members with mental well-being. From the case study: 

“Initial engagement for both solutions is impressive. Members are engaging for 15-minutes longer on average than The Big Know’s book of business. There has been high engagement in the Learn to Live program.”

Wellness program data is being used side-by-side with Artemis’ holistic health and benefits data to ensure these programs are delivering for members. Read the full case study here. 

Reason 4: Measuring Chronic Condition Prevalence 

Chronic conditions came to national attention in 2020 with the spread of COVID-19. As the disease was better understood, public health officials warned that the symptoms and risk of mortality from COVID-19 was much higher for people with the following pre-existing conditions: 

• Type II diabetes
• Cancer
• Chronic kidney disease 
• Obesity 
• Coronary artery disease, COPD or other serious heart conditions 
• Sickle cell disease 
• Immunocompromised state from organ transplant 
  

Other chronic conditions are also thought to cause severe COVID-19 illness, such as asthma, Type I diabetes, and HIV. Benefits managers and benefits analysts will recognize this list as having significant overlap with their top chronic conditions within their employee populations. 

Measuring chronic condition prevalence is no easy task if you’re relying on carrier reports, but a modern data warehouse can make it easy to see the numbers.

This level of insight is essential for benefits teams who are looking to save costs, track employee health, and intervene with the right programs for the right people. 2020 has revealed the deadly cost of many of these chronic conditions, and benefits managers are uniquely positioned to help people get the care they need to improve their health and wellness. 

Reason 5: Changing Your Mind (and your Benefits Strategy)  

Have you ever started down a path and found out you needed to change direction? Of course you have; it’s part of the working world to choose one strategy, tactic, or program, and find out you need to make a change. Changing their minds (and turning “the ship” with them) is something benefits teams are good at. 

However, there is often an opportunity cost when it comes to point solutions or benefits strategies. Going halfway down one path might involve months of implementation, dozens of employee communications, or even a whole lot of wasted spending. Healthcare benefits analytics is the key to changing course quickly and with minimal opportunity costs. 

Here’s an example: 

This dashboard shows one way the most forward-thinking employers also use data: to explore the potential ROI and success of new initiatives. This example explores the possible impact of adding a telemedicine benefit for this sample population. This is assuming 100% employee engagement, which we know is something employers and benefits advisors must actively encourage. However, 2020 has proven the popularity and need for telemedicine. According to national consulting firm Mercer, 69% of survey respondents have promoted their telemedicine programs to members during the COVID-19 pandemic. 

Benefits data like this can give employers a sense for the cost of implementing a telemedicine solution and compare it to their current spend on conditions that could be handled through this program instead. The Artemis Platform uses custom data models and apps to help benefit teams conduct predictive analyses like this one. In addition, our tools provide future cost estimates to better inform employers when setting budgeted rates for the upcoming year. 

These five reasons are just a few examples of how healthcare and benefits data is essential in 2020. Forward-thinking benefits advisors and employers are using their data to find insights, make changes, and create better health for their members. 

Are you interested in learning how you can access your benefits data? Watch our 2-minute demo video for a peek at our tools and services.