Companies are fighting with the high cost of medical care benefits for their employees. As companies prioritize the well -being of their employees, the benefits of medical care are often their highest expense, only exceeded by the cost of the goods and services they provide. The costs of medical care sponsored by the employer are expected to increase 9% in 2025.
Large employers can use data -based strategies to help reduce the cost of medical care. Here are three areas that employers can address so that medical care is more affordable for them and their employees without sacrificing quality.
1) Measure the results of LPG-1
The LPG-1 are a hot topic. This kind of drugs has existed for almost 20 years to treat diabetes, but the use has grown exponently to address obesity in recent years.
A recent KFF Health Monitoring Survey found that approximately one in eight American adults says they have a LPG-1 tasks. The drug class continues to expand with label expansions to reduce the risk of cardiovascular death, heart attack and stroke, as well as doxes of clinical trials in progress to bring to the GLP-1 measurements to the market.
LPG-1 will be a significant part of the panorama of medicines for the future preview. Employers must understand the financial cost and the clinical results they are achieving. However, measuring the success of LPG-1 requires data sophistication.
Employers must combine drugs, doctors, biometric, laboratory and other data to monitor the use and results. They must also understand how weight and diabetes management programs affect the results and know if they are obtaining a good return on investment (ROI). Beyond the use of medical care, disability and absence data can help employers understand the ROI from a productivity perspective.
Understanding the cost of LPG-1 and its impact on health can help a company determine how to manage these recipes in time.
2) Direct mental health and well -being
One in five American adults experiences a mental illness every year, and less than half of them receive treatment. Employers focus more and more on mental health to support the well -being of their employees. Many companies now provide tools and services proactively, such as private sessions with mental health professionals or that bring external speakers to talk about mental health issues.
To make a real difference, companies must connect people with the services they need. Several barriers can prevent people from obtaining the help they need: financial concerns, pessimism about treatments, the lack of support from loved ones, stigma or simply the perception that they handle it on their own.
Data can help improve well -being, especially when companies combine their data with sociodemographic data to obtain a more complete image of their population. Understanding more about their communities and their level of education or ethnic history can help employers adapt their approach to involve them with mental health services.
These evaluations are especially important for companies that use suppliers for well -being and mental health services. With the data, companies can hold their suppliers for the results. For example, the data can show how suppliers reach the members and if they reach those who most need help.
3) Negotiate the price with better information
Refund strategies are or the maximum importance. Negotiation better prices in advance will have significant implications for the affordability of the members, the health of the population, growth and profitability.
There are four aspects for the price analysis that each shoulder of the employer before negotiating benefit contracts of the health plan:
- Medicare repainization It is the Gold Standard Discount Baseline. It is an important data point because it is the common language used by payers, suppliers and consultants.
- Legible files of the machine (MRFS) —The transparency in the final rule of coverage requires that these files make health prices information more accessible. Keep in mind that the massive size of these files may be different to work, and health plans and suppliers can use different formats, which makes comparison difficult. However, they sacrifice a great promise and should be essential in any price analysis.
- REFOUND REFERENCE POINTS -The reference points at the market level that use paid claims are the best resource to tell employers what happened. These real world data are a good option to evaluate the precision of MRFS.
- Advanced analytical reports – Employers must be able to bring all the information to an environment where they can model it. Here, they can compare the current use and spending with competitive data points or evaluate how their contracts are configured.
If an employer knows which diagnostic groups (DRG) are promoting costs, that is powerful information when negotiating prices. These facts, together with admissions and claims, allow a more complete image and the ability to monitor changes over time.
Sophistication of data is essential to reduce costs
In the three areas, one or two data sources are not enough to face the challenge of dreaming health benefits costs. Companies must discover that trends affect their members use a robust set of cured and aggregate data sources. Data -based strategies will require a higher level of data sophistication than ever, but cost savings and high quality care protection are worth effort and investment.
Photo: Lerbank, Getty Images
Marcy Tatsch is executive vice president and general manager of Travens, a platform that includes insights solutions (Healthcare Analytics) and Marketscan (real world evidence). Previously in Merative, he also directed Cúram, our global solution to help government agencies to transform benefits. Before joining Merative, he served in several senior leadership positions in McKeson and changes medical attention, leading companies that attended hospitals and pharmacies with platform, financial and analytical solutions.
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