One of the comments I get most often when speaking to the benefits community is that analytics and business intelligence tools may be beneficial for large plan sponsors that have sub-populations and generate lots of data; like TELUS, with more than 30,000 team members plus dependents; but how can they help smaller plan sponsors?
Regardless of size, plan sponsors all have the same basic concerns:
- Are we getting the best value for our drug spend?
- What actions should we take if we are not?
- Is the plan sustainable, and at what cost?
- What risks do we face that would significantly affect our costs?
- What safeguards can we put in place to minimize impact?
Analytics can help answer most of these questions for plans of any size.
Gain the ability to model, simulate and predict
The sustainability of a plan means knowing how much plan costs have increased, what drives plan costs currently and what factors will drive costs in the future. Analytics also offers the ability to look at drug consumption and correlate it with factors such as health status, age and other demographical criteria; giving the plan sponsor the ability to model, simulate and predict what might happen to the same plan members based on the pooled experience of many other plans. The resulting scenarios offer “food for thought” about what to plan for and whether a current plan is effective.
Even in small plans, privacy is never compromised. Everything we do is guided by the highest standards in Privacy and Information Security from our state-of-the art Canadian data centres to our robust corporate security policies and practices.
Finally, analytics contributes to an equitably-designed plan because it provides the plan sponsors with a good understanding of how the plan is affecting the plan member’s pocketbook. By comparing to other groups, or looking at entire blocks of business, analytics provides reliable benchmarks against which to measure use, compliance and adherence to therapy. Not only do these issues affect the financial health and sustainability of the plan itself, but most importantly, the physical health and productivity of the plan member.
While the amount of detail and the way analytics are used may be different across different-sized organizations, plans of all sizes need good metrics that are simply stated and condensed, to provide a baseline understanding of what is going on and to identify early warning signals that things may be about to change.
Bryan Ferguson recently retired as Managing Principal of TELUS Health Analytics.