Brian Klepper, an analyst and consultant to the healthcare industry, yesterday published an article called Really Managing Care and Costs on the Health Care Blog which really hits the nail on the head. Brian understands the Healthcare Performance Management language and its underlying benefits.
Healthcare Performance Management (HPM) is based on the principle that unless you use business intelligence tools, with available claims data, to identify and proactively manage your plan in real-time, you are destined to do nothing more than react to rising costs through cost shifting or total benefit reductions. Many of our clients tell us that they never even knew that there data could be transformed into real-time, usable intelligence much like financial sales projections.
Using new technology, organizations are achieving new levels of savings and control over their benefit plans without shifting cost or reducing benefits. Plan sponsors are now able to create action plans focused on the areas of risk within their own plan and provide services and incentives to lower risk employee segments. As a result, better plan member health is being attained and better financial outcomes are emerging for the plan sponsors.
After evaluating real-time data, companies can address their plan’s high-risk employee population using incentive programs and services to educate them on becoming the best and healthiest consumers of healthcare. These proactive efforts help to lower catastrophic or acute costs while helping to increase overall productivity. Brian is right on when speaking to the needs of the 200-5,000 life market that is undeservedly and improperly counseled by brokers and carriers on the programs and technology available.
After all of the hoopla from the healthcare debate over the last two years, and the corresponding legislation that followed, it is now time for organizations to take control of their own costs and not leave it up to the government to find a costly and inefficient solution that ignores the realities of what is really driving runaway costs.
Brian’s examples and success stories further validate that HPM is here to stay. It is truly making a big difference to all who embrace this new model.
Chris Kaiser, WellNet Healthcare
