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The role of data management tech in next-gen healthcare benefits

David Morris, Cedar Gate Technologies
David Morris
David L. Morris is the EVP and Chief Commercial Officer of Cedar Gate Technologies.

The Great Resignation, subsequent Great Reshuffle and workforce shortages in key industries are making it challenging for businesses to fill open positions. In 2021, over 40 million workers left their jobs, reflecting the economic phenomena that reinforced an emphasis on worker expectations and directed a laser focus on the need for employers to offer next-generation benefits, preventing further career abandonment.

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Driving the collective move was a combination of essential and personal motivations: improved growth opportunities, remote work options and work/life balance. Moreover, in the wake of a jarring pandemic, wellness was at the forefront, driving employers to seek upgraded healthcare benefits to be as competitive as possible.

With roughly 157 million Americans relying on employer-sponsored coverage—far more than any other type of coverage—employers are in a constant struggle to address runaway costs and expenditures. Recent studies show that employee-sponsored health premiums increased 22% over the last five years, and 55% over the previous 10. Total health spending is estimated to reach as high as $15,500 per employee and up to $22,000 per family.

Along with circumstances surrounding a post-COVID-19 landscape, the simple reality is that employee benefits have become critical for candidates when considering a job offer. These factors, supported further by advancing analytics technology, have created a point of inflection in the transformation of healthcare delivery models.

Value-based innovation

Business and HR leaders are embracing next-level benefits aligned with their population’s highest priorities while also seeking solutions that keep the cost of healthcare low. When contemplating benefit plans, employers are pursuing a different type of strategy—one that is allied with value-based health care.

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See also: How technology can play a ‘critical’ role in building EX

A survey sponsored by the National Business Group on Health found that about 40% of employers take advantage of value-based benefit design. In its purest form, value-based care is about investing more resources in preventive care and chronic care management, which results in fewer costly hospitalizations and use of emergency medical services. Consequently, providers are incentivized to offer optimal preventive care to avoid unnecessary and often calamitous medical costs.

Increasingly, employers, HR managers and providers are adopting and implementing innovative data management technology that supports the delivery and management of the more effective, but highly complex, value-based care model. The new advancements in data analysis effectively streamline next-generation healthcare benefits.

Providers that are part of a value-based care delivery model have the increasing ability to access patient-level data at a granular level. This reduces gaps in care and enables the identification of health risks more quickly while allowing for more precise preventive treatment. The emerging and advancing capability represents one of the biggest obstacles overcome by new value-based care model technologies. Increasing precision and ability to access, process and streamline enormous volumes of patient data enable medical professionals to efficiently gain a 360-degree view of patient health and align evidence-based treatments. For employers, the result is a healthier workforce and lower costs.

Technology and value integration

A complete and thorough enterprise data management (EDM) system is the focal point of efficient healthcare software platforms. A key benefit to value-based care systems is their ability to access and process data from multiple sources, making it available for analytics, care management, care delivery coordination and documentation.

While current and outdated systems struggle to offer significant, accessible and applicable data from various sources, a fully integrated value-based care EDM produces consistent data that can be used by various technology applications to promote clinical quality and efficiency, benefiting both employees and employers.

Additionally, the healthcare ecosystem doesn’t suffer from a lack of data. Rather, data systems often are challenged to process an overload of information to make meaningful decisions. Value-based care EDMs can process large data streams from disparate sources and make them usable. This is an essential advantage that a value-based EDM platform gives employers when designing and administering benefits programs.

Care coordination and population health

Employers and employees can both benefit from a population health management approach as a result of the optimization of preemptive and chronic condition care.

Employers have the option to partner with advisors and health plans with technology that can identify key demographics and risk factors for a group of employees who might benefit from more intensive prevention and wellness programs. Once they are identified, using in-depth analytics tools, care teams can proactively manage clinical and financial risk within the population. Task-based workflow support can coordinate and align care team actions, patient engagement and interventions with the quality and financial objectives of the healthcare enterprise.

Related: How one beverage distributor tackled chronic employee illness

Additionally, by identifying emerging or high-risk employees grouped by specific clinical co-morbidity, or through a predictive risk model, employee populations with the greatest need can be targeted earlier for effective interventions—resulting in fewer urgent interventions and hospitalizations, thus keeping costs lower.

Keeping workers healthy not only reduces healthcare expenditures but also contributes to higher rates of productivity and lower rates of absenteeism.

Additional ways EDM solutions and analytics help HR and employee benefits teams:

  • Streamline workflows and automate the process of handling agreed-upon payment arrangements with care providers.
  • Assist organizations with meeting established goals to track employee health improvements with the objective of enhanced care quality.
  • Provide the necessary tools for report-sharing with payers and providers.
  • Streamline complex processes of health coverage through leveraging analytics that assists intermediaries and employers in measuring, predicting and reducing healthcare spending.

As the nation moves into the next phase of the pandemic’s impact on healthcare, company leaders and HR managers have an expanding set of solutions. Value-based care—delivered through innovative data management systems, advanced analytics and improved care coordination—is positioned to perform a crucial and growing role for employers looking to offer next-generation benefits, retain a healthy workforce and attract new talent.

Hear from leading companies about their healthcare benefits strategies at the upcoming Health & Benefits Leadership Conference, May 3-5 in Las Vegas. Click here for more information.