At Geneia, we serve a range of employer clients. Some are just getting started with healthcare analytics, and others like Curt have been actively working for years with the analytic insights for their employee population.
For employers new to analytics, the home page of our Theon® platform’s Care Engager® module has a wealth of information.
Our population measures display important, timely information such as the number of employees currently in the hospital as well as those recently discharged, the number who have not received primary care in the past 12 months and the number of high-cost members. Employers can self-serve these kind of rich population-level insights as well as data to benchmark the performance of their health plans.
For more savvy employers seeking more nuanced analytic insights, Geneia consultants can help clients uncover complex trends and correlations, determine statistically significant differences and identify opportunities for improvement. Recently, I had the opportunity to perform this level of deep analysis for one of our larger employer clients.
Here is a snapshot of the most salient and actionable findings we shared with them*:
- Subscribers v. Members - Enrolled membership for the group was about evenly split between males and females. But, at more than two-thirds, the employees or subscribers were predominantly male.
Why does this matter? The U.S. Department of Labor has found 85 percent of healthcare decisions are made by women yet this employer group had limited ability to communicate with the female membership. We recommended the group find ways for health education and preventive care information to be shared with non-employee female members.
- Non-Utilization of Benefits - In the previous year, nearly 25 percent of members did not incur any claims, meaning they did not access any healthcare services. It may be tempting to conclude these members are healthy and not in need of care. Yet, they are not even receiving preventive screenings such as routine physicals, immunizations and cancer screenings, all of which help avoid future costs.
- Emergency Department Utilization - Nearly half of all emergency department visits occur on Mondays, Fridays and Sundays, and more than five percent had a primary diagnosis of headache, cough or unspecified fever – all conditions that might be appropriately treated in an ambulatory setting. These utilization patterns suggest the use of primary care, telemedicine, the 24-hour nurse line and similar non-acute settings could reduce costly emergency visits.
- Prediabetes - Close to 30 percent of the membership is at risk for diabetes. The top three risk factors for at-risk members are:
Early intervention and engagement in lifestyle modifications are essential to preventing progression to the costly chronic condition of diabetes.
For this employer group, these findings led us to recommend they work much more closely with their health plan to provide benefit information and health education. The group also is considering benefit changes to incent members to access regular preventive services such as breast and colon cancer screenings and to encourage the appropriate use of the emergency department. They also plan to collect the email addresses and phone numbers for all non-employee members to more easily communicate health education information to them.
I am encouraged – as are our clients – that our analytic insights meet employers exactly where they are and offer information they can act on in the short term to improve the cost and quality of employee healthcare, and in many cases, employee satisfaction too.
*The numbers presented in this blog are representative examples based on the experience of a Geneia employer client.