Data Analytics

Data Analytics

Quote StickyAll-New Ad Hoc Analysis: Data Analytics

HollandStivers in partnership with HealthWorks Medical can now do even more with your data:

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•Reduce health costs by implementing a fixed monthly cost Medical Wellness Program.
            –Absorb non-catastrophic visits in-clinic so those claims are not charged to health insurance
            –provide essential wellness and preventative care services resulting in a gathering of needed information to drive down utilization and change behavior
•Create analyses and custom solutions based specifically on your group’s needs and data

Ad Hoc Analysis

•Allows us to get to the source of problem areas
•Breaks down data into targeted, specific segments to analyze
•Helps us expose meaningful details which allow you to develop specific solutions
•Answers questions such as:
          –Who is going to the doctor? Are they using in-network or out-of-network?
          –Who is using the emergency room most – employees, spouses or dependents? Why is utilization so high?
          –Why segments of the employee/dependent popular are utilizing preventive services the most?

Here’s an example of how we would use Ad Hoc Analysis as part of our overall Claims Analysis package.

Step 1: Benchmark

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Emergency room utilization is high

 

Step 2: Dig Deeper

 

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We find that the 4th most common reason for ER visits is ear/nose/throat claims, illnesses that probably shouldn’t need an ER visit.

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Continuing to dig, we find that employees are the highest utilizers of the ER for ear/nose/throat diagnoses.

Step 3: Formulate Solutions

So we know that:

•ER utilization is high
•One of the top diagnoses is one that shouldn’t be seen at an ER
•Employees are using the ER most

Consider options to address this problem:

•Redirect ER visits to HealthWorks and National Partners through Medical Wellness Program (available 24/7)
•Initiate a communication campaign to educate employees
•Increase the Emergency Room Deductible

ER visits are the highest during the weekend.

With the 24/7 availability of HealthWorks Medical and their National Partners, employees are redirected and receive in-clinic services reducing ER utilization.

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To see when a communication campaign would be most effective, let’s look at when the ER utilization was highest

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January and September were the most popular months for ER utilization for the diagnoses in question

We can model an increased ER deductible to demonstrate the financial and employee impact before you make any decisions

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Step 4: Implement Solutions

•You can decide based on our analysis and modeling whether you want to implement one or more of the following:
             –ER redirection to in-clinic services through the Medical Wellness Program with HealthWorks Medical
             –Communications campaign (targeted January and August, right before peak utilization)
             –Increased ER deductible

We’ll also provide the employee education materials for your communication campaign.

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