When the success and shortcomings of these healthcare providers and facilities is made public, it helps to foster an arena for constant competitive improvement in the marketplace. Providers and facilities are made more accountable and healthcare consumers get the proverbial “bigger bang for their buck."
Whether its Trumpcare or Obamacare – the name makes no difference when it comes to Population Health improvement. What the American people need is solidarity and a conscientious, diligent commitment to providing affordable healthcare to its citizenry. Citizens should in turn remain engaged and informed about the healthcare debate and how it might impacts their care. Below you will find important health reform information from Trumpcare.com, a site operated by HealthNetwork Group, an unbiased, consumer focused for-profit healthcare marketing company.
For self-insured employers, selecting a broker is without a doubt one of the most important parts of designing a health benefits plan. It’s important to select a broker who understands the nuances of plan design and who can quickly adapt to the rapidly shifting health coverage and policy landscape. Employers need an ombudsman, a consultant with the know-how, resources and technological tools, including predictive analytics, to expertly navigate and take advantage of the current healthcare system.
High-cost claimants are only a part of the equation. There is a secondary subset of the insured population who are at-risk of entering the 5-7% of highest cost claimants that predictive modeling can uncover and help address. Not all predictive modeling engines have the capability to identify this subset of the employee population, but with Advanced Plan for Health’s Poindexter’s predictive modeling capabilities, determining the likelihood of an occurrence of coronary events, neurological events, orthopedic events and chronic kidney disease is made easy. Once interventions are made to improve the health of at-risk patients, the analytics system can retrospectively report actual cost versus the original predictive model to measure the positive health and financial effects the interventions created. Without the predictive-modelling enabled ability to identify those at-risk and intervene with targeted prevention strategies, health plan optimization will always be an uphill battle.
Most people would not participate in a 5K run without training. Yet folks go for elective surgery every day without building their nutritional status and improving their physical conditioning. Studies over many years have shown the value of sound nutritional status on surgical outcomes like wound healing, faster recovery, shorter hospital stays and fewer complications. Gaining control of elective surgical preparation is a win-win for the health plan in terms of cost savings and for the patient, who optimizes their speed of recovery and minimizes the chance of complications.
The webinar included Business Insurance, Advanced Plan for Health, Turner Industries and BancorpSouth Insurance Services, Inc. and offered insights on how to leverage advanced analytics throughout the year at various points in the annual sales and service cycle. It also outlined real-world case studies of health data analytics in practice, resulting ROI and the many benefits analytics has on health plan performance and the competitive advantages it can provide brokers looking to set themselves apart from the crowd.
In recent years insurers and brokers have had to adapt to rising healthcare costs without much say in the matter. This is in part because brokers and employee benefit managers often have too much on their plates to sleuth out and address the costliest “blind spots” in health coverage. This has left many struggling to find a way to remain competitive in an increasingly technology-driven industry.
The current opioid epidemic has shed light on the shortcomings of many wellness programs and the lack of preparedness by case management teams to handle chronic conditions and or patient behavior, such as addictive tendencies or duplicate therapy. But are case management teams solely to blame for lack of effective response to this costly health crisis? The simple answer is, no.
Many case managers do not have access to the data or tools required to employ a compelling and value-driven prevention model. Hence, what we see today is very little accountability or effective case management. What’s needed most is quality data to guide active engagement with patients.
Engaging and educating healthcare consumers on plan benefits, cost-saving options, health risks, as well as the benefits of closing gaps in care can spur action and the desired results. But disconnected messaging via multiple outreaches can cause aggravation and discontent. Even leading to member attrition.