Health care is changing quickly.
Read about the top 5 trends in health care and the analytics you can use to navigate plan design with confidence.
SDoH Impacts
Point Solution Value
Total Well-Being
for Omni-channel Care
Deferred Care Habits
Read about key trends and what this means for employers.
We’re used to looking at a lot of healthcare metrics – utilization, costs, outcomes. Even just a little more data can tell us a lot more about people in context.
Check out how Plan Sponsors are surfacing measurable differences within their populations, by adding just a little more data into their analytics.
DEI initiatives need vision
born out of facts.
REAL and SOGI data as well as the HDMS social determinants of health (SDoH) enrichments allow a much deeper investigation into health patterns and costs.
Measuring these differences allows us to take what we anecdotally see or suspect, and support it with facts.
Collegaues focused on Diversity, Equity, and Inclusion (DEI) agendas are wonderful partners. Share these insights with them. The numbers give your organization a brilliant set of facts to help drive decisions aligned to company goals.
We’ll help you surface these insights at your organization. Ask to hear more about the possibilities.
Join the movement. We’ll help you get started on measuring how healthcare needs and patterns change across different subpopulations at your organization.
See how easy it is to look at how social determinants of health influence your population. Find where inequities exist and track progress of program efforts.
SDoH analytics requires a lot of data, and different types of data. Claims data tells us about health care visits. Digital device data tells us about daily health. And special data sets apply what we know in a way that delineates the social and environmental factors that could influence each member.
In SDoH analytics, we understand each person as an individual and in context, but look at a community as a whole in aggregate, to see what trends and patterns emerge.
Here are 5 important aspects to consider, and tips of what to look for, so you can trust the insights in your SDoH analytic endeavors.
Here are two tips for building out a new solution:
Here are two tips for building out a new solution:
HDMS offers over 25 SDoH indices and dimensions.
Start with composite indices that allow you to look broadly across a number of factors at once. Use focused indices to support very specific or nuanced investigations, like food access or social isolation. They can also be used together – for instance the transportation index and the technology index example we shared above.
One last tip:
TIP: Enriching claim data delivers fast and intuitive investigations. This makes SDoH analytics easier too.
Enrichment can have many forms: classify claims by episode treatment groups (ETG), apply pharmaceutical classifications, and flag specialty druges. Enrichment processing also identifies gaps in care and low value care and makes it easy to surface these individual moments into analytics.
ER visits that have been classified using the NYU methodology allow you to quickly look at who visited the ER for non-emergent care, just by using a few filters. Now think how powerful it is to further see these visits by income index.
Read about Enlight and contact us with any questions.
Point solutions have been a great way to enhance benefits and provide care for a targeted need.
Large employers and plan sponsors have on average 9+ point solutions as part of their health and wellness benefits. But as point solution costs add up, the pressure increases to understand, and sometimes PROVE, the value.
Most firms have programs that help workers identify health issues and manage chronic conditions (health risk assessments, biometric screenings, and health promotion programs).
83% of large firms offer a program in at least one of these areas: smoking cessation, weight management, and behavioral or lifestyle coaching.
Source: Kaiser Family Foundation study
So, here are three best practices to consider, to deliver business decision-ready analytics, about the value of point solutions.
Here are two more pro tips:
Here’s a good example from our client base: This national retailer wanted to measure the value of a Center of Excellence strategy for heart conditions. The metric strategy compared a well-defined pair of cohorts that looked beyond traditional utilization and cost metrics. We helped them also include mortality rates (COE – lower), returns to work (COE – faster), outcomes (COE – better), and company satisfaction (COE – higher). Yes, that’s right – employees actually reported a higher employee satisfaction rate on the survey following a major episode of care.
There will always be a portion of a population that is engaged in their health and wellness. Your data can tell you who this population is, and provide insights that help you identify more people “like them” that you can target and pull along, therefore increasing program value. Also consider if the engaged audience would have been healthy or well without the special program, in some other way. Is it the program – or the people – that are providing the results you see?
Analyze for the big picture and long term.
Choice might be the right choice. The optimal strategy may not be selecting the best performing program in some cases. Use data to confirm if similar point solution programs are engaging the same or different audiences.
One self-funded employer had two somewhat similar wellness point solutions – Solution A emphasized “exercise and feel better.” Solution B emphasized “Eat right and feel better.” They both showed value – which one should they keep? A deeper investigation of the data revealed that the solutions were in fact engaging somewhat different audiences. The self-funded plan sponsor found they increased the value of BOTH point solutions by understanding the demographic nuances, and creating more targeted communications and incentives that used these insights.
Design Early Indicator metrics. Don’t wait for results (e.g., traditionally after year 3 of data is collected and analyzed). Design metrics that act as leading indicators. After year 1, plan to optimize and performance tune. Move the conversation. Avoid “Wow – it looks like our MSK program had trouble engaging our guys in the warehouses even after 3 years,… should we look into a different solution or approach?” Prepare for, “Wow – it looks like our MSK program is having trouble engaging guys in the warehouses – what’s our plan to tackle this as we plan for year 2?”
Leverage solutions that package this data for you. Data that provides insights into social determinants of health can be time consuming to assemble into an analytic environment and then align to member health data. And yet it’s so powerful for insights. Your analysts time is better spent using this data as opposed to prepping it manually.
We evaluated medical and dental claims for diabetics after the introduction of a new Virtual PCP program. The solution was selected after seeing a statistically significant difference in PCP utilization across various household income segments. We created a specific scope around diabetics to study impacts on utilization, medication adherence, medical costs, and co-morbidities in mental health. Not all investigation can rely solely on data. The task force team worked with “Voice of the Member” groups, formed based on specific demographics. They focused on understanding context and color behind the numbers. Transportation, time away from work, and caregiving themes arose in the care access category. Other reasons were also presented, but offered less immediately actionable solutions.
With less time prepping data, the team had more time to dig deep, address quantified specific barriers, and is now measuring impact.
Learn more and contact us with any questions.
Did you ever have a home improvement project that finished late and cost more than you expected? How about a technology implementation that finished late and cost more?
You are more likely to be on-time and on-budget if your plan is thoughtful and reflects your reality. Don’t you want to have confidence knowing what you’re really getting into?
So, here are three tips to set you up for implementation success when it comes to health analytics:
Tip! | Discuss what will be problematic or painful based on your experience and what you are moving away from. Are those complexities appropriately addressed, cared for, or resourced? Think about metric definitions and consensus, data quality, data reconciliation, matching and integration across sources, and slowly changing history. |
Tip! | Before your implementation starts, refresh your knowledge of the day-to-day contacts, authorities, and any contractual SLA’s you have in place. If there will be costs associated with establishing new feeds or data interfaces, identify those early. |
Tip! | Use phase 1 for quick wins. Standard sources generally seamlessly populate the most common views. Users feel like they get a lot out of the gate and that helps tremendously with adoption. |
Remember, you’re better off with an implementation plan that’s realistic rather than one that sounds like a dream but doesn’t work well for you in the end.
Maybe they act upon facts and share these openly with you?
Even when it’s not great news?
While everyone works to meet Transparency in Coverage regulations, we see the chance for you to leap ahead. Anticipate where the market is going and offer more than traditional plan sponsor reporting – bring your plan sponsors business transparency, strategic plan performance transparency. You’ll earn their trust; you’ll be rewarded with retention.
With major industry changes, new care options, and changes in care needs, people have lots of new questions. Be the health plan that easily gives plan sponsors answers, even to hard questions.
Employers benefit because health benefit satsifaction is a contributing factor to employee retention. With the right analytics, it can be easy to find opportunities to improve, maybe by introducing additional plan options. Yes, that’s right. Design analytics that introduce the potential value of your buy-ups. With better plan performance everyone wins as health care costs lower overall.
In an industry built upon trust,
Embrace it, lead with trust
Increase plan sponsor trust with an analytic strategy that delivers better plan transparency, too.
You’ll deepen relationships, earn loyalty, and retain your customers.
What could controlled plan sponsor plan performance transparency look like?
Self-service analytic front-ends are what people want, to explore data. But the secret is the data itself. If you want to focus on using data for plan performance improvements, your analytic views will naturally be very specific to your business.
Take a peek at HDMS Enlight™. Imagine plan sponsors with access to data and analytics you choose or design. See teams working side by side with accounts, helping them to optimize and get the most out of your thoughtfully designed plans and networks.
(yet verify – it’s ok, we would too.)
How are organizations approaching SDoH in their analytics? What are they doing given the insights and measurements they find?
Here’s some specific examples of work going on within HDMS clients. You can use these projects to understand the analytic possibilities available with our SDoH capabilities. And even more importantly, see how organizations are taking action upon insights and driving innovation.
Click here to see some examples
Score big for communities
HDMS clients – have your team walk you through available possibilities. There’s so many new options. Where will you take this next?
We’ll help tailor new analytic views to any specific needs you have.
How are organizations approaching SDoH in their analytics? What are they doing given the insights and measurements they find?
Here’s some specific examples of work going on within HDMS clients. You can use these projects to understand the analytic possibilities available with our SDoH capabilities. And even more importantly, see how organizations are taking action upon insights and driving innovation.
Organizations are using SDoH Analytics to tackle:
Here is a typical SDoH dashboard in Enlight.
Get an immediate understanding of the basics – things like care gaps by Socioeconomic index
And more focused investigations like mental health needs for disadvantaged segments.
HDMS clients – have your team walk you through available possibilities. There’s so many new options. Where will you take this next?
We’ll help tailor new analytic views to any specific needs you have.
Published in HealthPayerIntelligence
Authored by Rani Aravamudhan, Senior Clinical Consultant, HDMS
Member programs encouraging mental health and wellness have increased in popularity lately among health plans and sponsors. There is a growing consensus that a happy, healthy workforce can lead to better business results. Consequently, promoting mental health strategies is considered a “win-win” proposition.
The question is, how do we quantify the wins?