Today’s benefits consultant has been tasked with bringing innovation to their clients that can reduce risk or reduce costs associated with their client employer’s health care expense.  An employer’s historical and present-day data will contain evidentiary information that can drive future risk management strategies; however, many analytics platforms do not necessarily yield detailed instructions concerning actionable items found within the data analysis.  Many platforms can add numbers and rank cost drivers but deriving the pearls of actionability from the data platform oftentimes requires expertise in various disciplines (i.e., epidemiology, wellness, insurance, etc.).  Based on this fact, how can a benefits consultant become familiar with navigating and deriving risk management innovations through the use of advanced data analytics?   It all begins with developing an understanding of the evolution of risk and potential solutions that can be paired with this risk for amelioration.

In order to better understand bringing meaningful use to data, it all begins with the question “What is driving costs or risk?”  And the second question is: “What can I do about it?”

Below is a simple analysis (Table 1) that segments a large employer’s medical spend into 10 separate spending ranges.  At first glance, in 2014 and 2015, approximately 60 percent of the population spent less than $900 annually, yet only accounted for less than 4 percent of the overall expenditures.  The portion of the population that is driving the overall costs are the groups spending between $5,000 and greater than $50,000.  These groups accounted for 85 percent of the overall expenditure in 2014, and only 16.8 percent of the population in 2014 accounted for this major expenditure. The trend holds fairly steady in 2015.

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