4 Ways to Leverage Your Claims Data to Unlock Better Healthcare

Let’s cut to the chase: your population health insights, such as claims data, can be one of the most valuable resources in the pursuit of better healthcare for your employees. It gives an accurate picture of where your people are getting care, what types of care they’re receiving, when they aren’t getting care, and how much it all costs.

Equipped with this information, you can use it to refine and improve your healthcare benefits strategy. Let’s look at four ways you can use this data.

Optimized Care

When claims data is shared with a member’s primary care team — particularly a dedicated advanced primary care partner — they’re able to ensure the member gets the appointments and care they need, when they need it. Primary care teams can optimize care around your members by conducting follow-ups, refining treatment plans, and providing medication support, which leads to better health outcomes and lower costs. Seeing instances like missed prescriptions or skipped visits means care teams can better support members in a more meaningful way.

Strategic Insights

Population health insights provide a “big picture” view of your population’s healthcare needs. With safe and secure access to this data, both data analysts and providers can help close care gaps. For their part, analysts examine the historical needs and behaviors of your members to paint a detailed picture of the kinds of care and support they need now and may need in the future. This analysis empowers organizations to develop detailed and highly relevant benefit strategies that meet people where they are with the types of care they actually need. Without this data, organizations waste time and money by only being able to guess at which types of care are best for their people.

When providers have access to this data, they’re able to see when members are getting care in the community, like in the emergency room, for conditions or symptoms that could have been handled at your health center or Digital Wellness Center. With this information, they’re better equipped to educate members on where to go when they need care. Not only does it provide a member experience because they can receive care quicker, but it also positively impacts your bottom line by avoiding costly trips to the ER.

Engaged Members

For most organizations, healthcare costs are driven by a small segment of their populations. Claims data lets you take a closer look at this population to see what high-cost conditions they are dealing with or potentially at-risk for. You can then work with your healthcare partner to proactively engage those members and encourage them to visit the wellness center to keep their health on track. This tailored outreach helps them avoid serious, disruptive medical events that carry significant health concerns and increase costs for you and the member. Proactively engaging your high-cost, high-risk members not only helps them stay healthy, but it also provides a better, more personal healthcare experience.

Population Equity

Large organizations have highly diverse populations. The environments your employees live and work in won’t all be the same. Some people may face barriers to using their healthcare that others don’t. For example, an employee may skip care because of a language barrier, or they may worry about finding reliable transportation to the clinic. Your population health insights can highlight who isn’t getting care, empowering you and your health center teams to start closing the gaps. The result? Increased access to equitable, relevant care for every member of your population.

Making the most of your claims data requires a thorough analysis and the ability to refine and implement new strategies. This information can make good healthcare great, and great healthcare exceptional.

To learn how Premise Health can help you analyze and leverage your population health insights, get in touch today.