Whether you are an HR professional working to improve thehealth of your population or a consultant working to manage yourclients’ health care spend, you are undoubtedly familiarwith the health markers that have become ubiquitous throughout theindustry. The more employers segment their population into “atrisk,” “moderate,” and “healthy” members, the more empowered theytend to feel. Instead of waiting for the costly onset of chronicdiseases, these markers have created a guide to address problemsbefore they get out of hand. Your employees stay healthier, and sodoes your bottom line. It’s a win-win, right?

Unfortunately, it’s not that simple.

These broad risk categories offer plenty of benefits. Theyrepresent an opportunity to monitor a company’s population forchronic conditions. They allow you to design intervention programsthat will more effectively target spending categories. They alsoallow you to tailor communication and education programs tomaximize engagement. They even give you some nice-looking charts topresent to the CFO. That is why we are seeing more employersincorporating biometric screenings and risk stratification into themeasuring and reporting associated with their wellnessprograms.

Ranging from venipuncture to finger sticks, these screenings aremore widespread than ever, and they are dictating where the dollarsflow for wellness initiatives. In fact, 81.5 percent of America’s“Healthiest Employers” conduct biometric screenings as part oftheir wellness program. Yet, even with this rapid adoption,employers still have large blind spots in viewing the health oftheir population. In this article, we will explore theseareas and offer insights that can help brokers and employers alikeminimize these blind spots in their populations.

Employers: What you don’t know can hurt you

Risk categories can be powerful guides and indicators for thehealth of your population, but are not comprehensive on their own.Nearly every organization has a segment without biometric data. Infact, based on the data we’ve seen from our health analyticsplatform, employers have, on average, 89 percent of theirpopulation in an “unknown” risk stratification. This “unknown” riskcategory is often overlooked, and it can have hugeimplications. Our platform has uncovered that, while average costsin your “unknown” population can stay relatively low, thevolatility in this cost can be extremely high, representing realdanger to self-funded employers.

This fact can be jarring, but it is representative of today’semployer. Your unknown population can cost you more than your mostat-risk “known” population. So, where do these large swaths of“unknowns” come from?

It is important to note that an employer will seldom, if ever,have 100 percent participation in a screening. For starters, yourpopulation isn’t static. Between new hires and terminatedemployees, your population is in constant flux, meaning that yourbiometric report from six months ago has been out of date forapproximately five months and 29 days. Furthermore, it is even moredifficult to get spouses, partners and dependents to participate inthe company-sponsored screening, even if they’re on your healthplan.

To illustrate, let’s take a sample employer populationof 1,000 members.

• If we conservatively remove 50 percent for spouses anddependents, we’re left with 500 employees in our population.

• Let’s now assume there’s biometric participation by half of ouremployees. This takes us down to 250.

• This means that you’re making wellness investments andprograming decisions based on knowledge of only 25 percent of yourtotal population.

For many HR professionals, this fact can be daunting. Trying tomake data-driven decisions with such a small amount of data can beterrifying. What’s worse is the fact that this “unknown” piece ofthe pie can end up costing you more than even your biggestidentified risks. That’s where a strong, data-driven partner cancome to the rescue.

Brokers: The right data can make you a hero

As technology changes the health insurancelandscape, brokers are increasingly looking for ways they canprovide more value to their clients, and this challenge presents aremarkable opportunity for forward-thinking brokers. In the past,employers looked to their broker strictly for foundational plandesign help followed by retrospective reporting throughout the planyear.

Today’s employers, however, are far more sophisticated. Theyview their brokers as consultants with expertise in designing plansthat can maximize their population's health and financial outcomes.In the past, this kind of insight would require knowledge-intensivework behind the scenes. You would need to sift through carrierreports, vendor presentations, and spreadsheets to deliverrecommendations, and this often couldn’t be delegated. This made itcost-prohibitive for many brokers as they tried to contain costsfor their clients.

Unlike your brokerages of old, you have access to healthanalytics tools and intelligence platforms that make it easier thanever to glean insights from this data, and generate predictiveinsights. This means that you can more easily identify leadingindicators of health in your population and address them beforethey become an issue, instead of looking at lagging indicatorsafter the fact. This means smarter decisions, based on cleanerdata, leading to better outcomes.

As illustrated above, if the “unknown” population is removedfrom this equation, there is a chance that the intervention andengagement efforts aren’t targeting the key drivers of poor healthand runaway costs in a population. Today’s health intelligenceplatforms allow brokers to easily filter the population data todiagnose and recommend solutions that can truly impact theorganization. Then, they can present a course of action that withgreater accuracy.

How to identify and close knowledge gaps

The process of identifying and closing these gaps starts withdata. Historically, data has been messy. They live in cumbersomecarrier reports, are rarely up-to-date, and can’t be easilysearched or filtered when you need a different view.

This is where a population health analytics tool comes in handy.These tools allow you to get all of your information into onesingle place to view the whole population and to make intelligentdecisions. From there, you can start identifying problemareas.

The first and easiest step is to remove the “unknown” members.That way you can compare health trends, costs and risk areas of theknown group versus unknown. If you have your data available in aspreadsheet, this could be done with a pivot table, but you’dlikely benefit from real-time software to augment your statisticalprowess.

Once you know how to leverage it, data can become your strongestally. As you get organized and have the ability to make real-timeadjustments and decisions, you can then tackle even more complexissues within a matter of minutes, such as filtering a populationby location, job type, or tenure, to truly develop a targetedintervention strategy.

Takeaways: 3 things you can do today

Simply by reading this article, you’ve taken a giant step in theright direction. Now you know what you don’t know, and you’re readyto take action. You’re at a crossroads. If you’re truly ready totake your insights to the next level and more accurately measurethe health of your population, here are a few things that you cando in the immediate future.

For brokers:

Evaluate your groups’ data sets to see what might bemissing - Try to identify any gaps in data before youcraft a strategy to increase participation in any program. Afterall, you want to ensure that you’re collecting all relevant data asyou drive new “unknowns” into the “known” column.

Establish a plan to close the loop - You’re thetrusted advisor to your clients. They look to you for guidancearound tough benefits and health conversations. Provide thatleadership here by providing your clients with a clearcommunications strategy to increase participation in these screeningprograms, and work with your trusted biometric provider to schedulemore frequent screenings to close the gap.

Develop a feedback loop within this population- Just as preventative maintenance is the easiest way toprevent poor health in your population, it’s also true of yourdata. By leveraging a data reporting tool that can update andchange with your groups’ populations, you can identify unknownpopulations as they develop, and catch them before they have theopportunity to surprise you with high claims. This reporting loopshould be accurate, reliable and flexible enough to change with thepopulation.

For Employers:

Identify what data sources are available - Sitdown with your broker or analytics team and ensure that all of yourdata sources are being incorporated into your decision-makingprocess. These sources could include medical and pharmacy claims,lab or biometric results, or data from your clinic and interventionvendors.

Align your strategy to today’s known population- Next, you’ll want to take a hard look to ensure yourcurrent health and wellbeing strategy is aligned to your currentpopulation. Your evaluation will still be skewed, as you don’t havea comprehensive view of your population, but you should have aclearer picture with all of your data on the table.

Craft a communication strategy to move people from the“unknown” column - Finally, you’ll want to put yourcommunications hat on and create an internal plan that canarticulate the value biometric screenings to your population.There’s also an opportunity to work with your vendor to schedulemore screenings throughout the year to close the gap on the“unknown” population. The bottom line is the more you know, theless can surprise you.

The bottom line is this: If you still have a large portion ofyour population showing up as “unknown,” when measuring riskstratification, you have risk. By following the guidance in thisarticle, you can dramatically reduce your “unknown” population andput your team in a position to have a larger impact on yourpopulation’s health as a whole.

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