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Employee benefits advisors and HR professionals are often overwhelmed by their carrier reports. They are usually looking to identify a handful of smart strategies supported by their data. But it’s not about the claims data; it’s about the strategies the data can inform. Where and how should we invest and what will be our metric for success?

Brokers and other advisors to employers in this area often don’t have the clinical resources to meet the demands of today’s health plan data. Newer treatment and diagnostic technologies, rare diseases, specialty medicines and new places of service introduce increased complexities to the clinical issues that should be considered when thinking through new strategies for employer clients.

There are two ways to think about using medical and Rx claims data: 1) What is our data telling us to do? 2) Can we ask the data about a strategy we’re considering?

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