Standard benefits reports aren’t exactly riveting. They aren’t the shiny new thing that presenters at benefits conferences are promoting. They don’t hit on hot topics like diabetes care, mental health and wellness, or COVID-19 risk assessment. But they are a crucial part of any benefits team’s day-to-day functions.
Just as an author must take the time to proofread their work, or a truck driver has to stop for gasoline and oil changes, standard reporting is the “maintenance” work that benefits professionals do to keep their plans functioning and their team working at full steam. Today, we’d like to highlight one of the most important standard reports, the Executive Summary.
The Executive Summary is the 10,000-foot view of your employee health and benefits. It most often focuses on what an executive team member might want to know:
This might seem like “Benefits 101” information, and that’s because it is. We hear from employee benefits teams and advisors all the time who get stopped in the hallway or emailed out of the blue by their CFO or another leader within their organization. They saw something about rising prescription costs on the news, or maybe their spouse tried to schedule a doctor’s appointment and found their old physician is now out of network. They expect fast, accurate answers from the benefits team, and an Executive Summary is one essential tool in the toolbelt to help answer these questions.
Artemis Health and many other data platforms include Executive Summaries as part of their standard packages. It’s one of our Standard Stories, which includes other pre-built reports on topics that are important to benefits teams. Along with Population Health, High Cost Medical, Network Utilization, and several more, these Standard Stories give immediate answers to common benefits questions.
A helpful, accurate, and comprehensive Executive Summary should include some key healthcare analytics data and just enough detail to meet the audiences needs. You don’t necessarily want to see ICD-10 codes or breakdowns by procedure types, but you do want to have some key information as a jumping-off point for further analysis if needed. Here are five things you should look for in a Benefits Executive Summary.
A comprehensive Executive Summary should show the benefits team how employees are utilizing different benefits plans and carriers. Most self-insured employers offer multiple plans to meet employee needs. They often work with a number of carriers in different states, and they strive to provide benefits that aren’t “one size fits all.” After all, the benefits usage of a young, healthy office worker are going to be wildly different when compared to a union retiree from the manufacturing industry. Employers often have many types of roles within their organization, so their benefits plans are tailored and unique to suit these employee needs.
Here’s an example from the Artemis Platform of how plan enrollment can be displayed in an Executive Summary:
This sample data shows an imaginary employer offering five different plans and how many employees are enrolled in each one. This gives benefits professionals an idea of which types of plans are most popular, and provides the opportunity to dig further into why this might be the case. While an Executive Summary will include a chart like this one, other functions within a full-featured data platform will let you look at utilization by plan, overspending by plan, and much more.
Benefits experts need to keep an eye on health risk scores, which are weighted indicators of population health. Risk scores are used in other disciplines, but for healthcare and benefits analytics, it generally indicates how likely it is that a member on your plan will experience good or poor health outcomes.
A generally low risk score will be 1 or below, while higher risk members may have risk scores over 2. A good Executive Summary should detail the risk scores of your population over time and include additional information, like what percentage of your members have a chronic condition, how their scores are changing over time, and what costs may be associated with high risk members.
We recently wrote about how risk assessments can be used to help benefits professionals plan for COVID-19 responses and return-to-work strategies, and that’s just the beginning of how these types of healthcare measures are being used. Risk scoring is helpful when planning for costs, identifying gaps in care, and rolling out new wellness or care management strategies.
If you’ve been asked for any reporting by a C-suite member or other executive, you’ve probably been asked about medical or prescription costs. The cost of benefits for one employee is roughly $15,000 annually, and it’s rising (sometimes by double digits) every year. Executives at self-insured employers will want to know how to plan and budget for hiring and these annual increases in healthcare costs.
Here’s how an Executive Summary can help them understand the cost of employee benefits claims.
There are some key metrics that an Executive Summary should track:
This sample data shows medical total allowed amounts per member are rising sharply, so that’s something benefits teams will want to address. However, it also shows that the costs associated with high cost claimants are going down compared to the prior period. Benefits teams can share this data with executives to show progress on their initiatives and budget for future costs.
Benefits Executive Summaries often showcase not just “what’s happening” with benefits, but “who it’s happening to” as well. This is why you should look for some basic demographic data in your Executive Summary report. As mentioned above, many organizations track high cost claimants or those with chronic conditions as part of their healthcare analytics strategy. This gives them key information for making decisions on plan types, costs, and point solutions to help people lead healthier lives.
But healthcare outcomes are also associated with other demographic data, like age, gender, geographic location, financial health, and many other factors. You’ve probably heard a lot about the social determinants of health, and these are some of the indicators that can tell benefits teams if their populations are healthy, at risk, or in need of interventions.
Look for demographic data like these:
Age groups, gender, and family size give you a good sense for what health risks and needs your population may face. You should also look for the ability to filter all your data based on detailed demographic information like geography, office location, job category, and more.
Any next-generation data solution should give you the ability to dive deeper than an Executive Report, and ideally, it will allow you to explore further across all your data types. The Executive Summary is just a jumping-off point for additional analysis, insights, and actionable data.
Artemis Health’s Executive Summary report, like all of our Standard Stories, lets you filter by age, gender, location, plan, member relationship, subscriber status, and any other breakdown within our platform. An Artemis user could take any of the information above (medical costs, risk scores, etc.) and filter them to show just members who are female, or just members who are listed as spouses, and so forth. It takes an Executive Summary and lets you add features and insights to create a living, breathing analysis that can be shaped to your organization’s needs.
This is one key advantage of using a data warehouse solution, along with a consultant or broker who can help with analytics. Benefits professionals relying solely on carrier reports or yearly analysis from vendors won’t be able to get a holistic view of their benefits or dive deeper into member health and wellness.
As the benefits industry begins seeing the impacts of COVID-19 on their members and organizations, we predict that Executive Summaries will be more important than ever. Leadership teams will want to have a better understanding of employee health, risk, and benefits costs so they’re better prepared for future waves of COVID-19 or other health threats to their employee populations.