Using claims data to drive a population health program

Tuesday, August 23, 2016 – Sharon Schneller, RN

Are you experiencing continual increases in your healthcare costs? If your inpatient hospital costs have increased significantly, do you know why? According to a recent study from PwC’s recent Health Research Institute report, healthcare costs are expected to grow 6.5% through the next year.

The good news: this projection is not double digit growth as experienced over that past several years. The bad news: this is still expanding at a rate faster than the overall inflation rate, and many employers are still experiencing double digit increases for a variety of reasons.

Employers can manage medical cost growth by incorporating a several very effective tactics in health plan design. Often employers want to know if there are other options that can mitigate your rising trend in healthcare expense. The answer is “Yes!” Consider a population health management program in your workplace.

What is a population (employee) health management program?

There are several population health management definitions. A common definition is: “A comprehensive and integrated approach to improve the health outcomes of a group of individuals.” So what does this mean?

Think about your employees and their families as your overall population. Your healthcare and business costs are determined by the health of your population and how they manage their health and well-being. Aggregate financial and utilization data provides a high-level overview of the cost. However, it does not allow you to drill down and look for the specific drivers for the cost, or answer these questions:

  • What is the risk associated with my employee population and specific members?
  • How much does the population and individual members cost our company?
  • Are chronic conditions playing a role in my employees health?
  • Are my employees receiving appropriate care at the right time and place or do they have gaps in care that may impact their health?
  • Are my employees receiving the preventive services to keep them healthy?
  • How are my employees utilization healthcare services across the continuum?

Using a robust clinical data analytic tool along with the help of skilled health management consultants,, employers can answer these questions and identify those hidden healthcare costs.

To learn more, join us for our webinar, “Using claims data to drive population health strategies for employers,” on September 28, 2016.

Our Health Management Solutions team can partner with you to develop a plan that will meet the needs of your company and your team. If you are interested in more information about population health or wellness programs in general, please contact us.

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