At a time when data analysis has never been more important for managing employee health benefit costs and clinical outcomes, reporting is critical for self-funded customers that customize their health plan coverage. Timely financial reporting is necessary to know how much they’re paying in medical claims, while utilization reporting helps them understand the types of services health plan members are receiving. This drives decision-making around plan design, incentive solutions and member advocacy, all of which are critical to the success of a health plan, explains Jason Stephen, vice president of information and analytic services at UMR, Inc., a UnitedHealthcare ASO solution.
The key is to access data in a way that’s timely and actionable, he says. For example, UMR offers employers access to self-service reporting tools that are updated daily with only a two-business-day lag versus waiting for carrier or TPA reporting to be refreshed on a monthly basis. Another solution is for employers to contract with health analytic vendors to create their own data warehouse.
Stephen notes that the more employers understand which conditions are driving their healthcare spend, the easier it is to decide on specific care management solutions. Drilling down into claims data can help customers understand their utilization patterns and ensure that members are receiving the right care in the right setting by a high-quality provider. He predicts artificial intelligence will continue to spot trends lurking in the data, noting that sophisticated algorithms extract insights quickly and efficiently.
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