For self-insured employers, one purpose of predictive analytics software is to tell a narrative – to expound on the history of an employee population’s health. Lab data, claims and biometrics data (to name just a few data-sets) are analyzed and structured in a cohesive, refined and chronological order to help predict risk and avoid substantial health plan costs.
While health care costs vary significantly from market to market, and some areas have higher operating expenses, price transparency is considered one of the ways to stabilize health spending and – in turn – long-term, macro financial stability in the United States. That’s why more than 30 states have passed or have proposed legislation to increase healthcare cost transparency.
Hypertension (High blood pressure) affects more than 75 million — or nearly one-third of American adults according to the Centers for Communicable Disease (CDC) in Atlanta. About 28 percent of American adults ages 18 and older, or about 59 million people, have pre-hypertension, a condition that raises the chances of having heart disease or stroke or developing chronic kidney disease. Hypertension is often called the “silent killer” because many people do not have symptoms when their blood pressure is elevated.
In addition to the human toll, “high blood pressure costs the nation $46 billion each year” according to the Centers for Disease Control. “This total includes the cost of health care services, medications to treat high blood pressure, and missed days of work.”
Technology has significantly advanced within the healthcare industry over the past decade. From the Affordable Care Act to wearable device technology, healthcare is transitioning to a more comprehensive, accessible, interoperable and personalized way of managing population health. Employers, health insurance brokers and health plan providers who do not adapt to the rapidly shifting health management landscape will struggle to keep up with the clinical and financial outcomes of those who embrace the new opportunities provided by modern day technology.
To nurse care navigators, care management is exactly that – managing people with care.
Mentoring clinicians and health plan professionals in learning how to guide and support people, wherever they are on the healthcare continuum, is my opportunity to pass on the secrets of population health management that so many wonderful professionals have shared with me.
Making a difference in people's health, while optimizing resources so that people and health plans get the desired results, is my idea of success.
So, where are your hidden health-related cost centers? The same places they’ve always been: In plain sight. But for the lack of data transparency and integration of data tools and services, they remain elusive to spot. To uncover these cost centers, consider partnering with an analytics firm that not only can access data sets from everywhere patients access healthcare, but also combine them to create nuanced action lists.
Unlike the private-sector health plans, Medicare has a “Most Favored Nation” clause which means that providers cannot give a discount on billed charges to health plans or others that is greater than what they give to Medicare.
We are now in the midst of open enrollment season, which probably means you have been bombarded with health insurance plan options and are now ready or nearly ready to make a choice. Employer’s want to make sure you choose the plan that not only makes sense to you and your lifestyle, but to the company’s bottom line as well.
Here are a few quick tips to consider in choosing the health plan that works best for both parties.
Population health has many definitions which are often pigeonholed to fit a specific market or agenda. Its end goal, however, is unequivocal: to manage the health of a given patient population to improve outcomes and keep costs in check. And without recent advancements in health technology, data aggregation and data analysis, case managers, data scientists and benefits managers alike would not have the tools and actionable intelligence necessary to make lasting improvements to the populations they manage. Wellness programs would not improve a health plan or reduce costs as effectively if case managers were missing crucial data sets of the population.
Every year a vast selection of healthcare conferences, expos and tradeshows are carried out throughout the country. Undeniably, some of these shows provide greater target-rich environments for prospect8ng and lead-gen, opportunities to showcase or advertise your product, and to establish your company or brand as a leader in the industry. Let’s look at some of the top shows for Population Health, Health Benefits, and Health Plans for 2017.