At CBG, we work with our TPA partners to integrate our reporting and analysis capabilities with those of our data analysis partners, specifically Zywave. This integration enables us to provide our self-funded clients with the information they need to improve the efficiency, effectiveness and appropriateness of employee health care.
After decades filled with every fad from managed care to large carrier network discounts, our clients know that the only way to truly control costs is to improve health and lower utilization. And this is only possible when everyone involved – employees, employers and providers – takes responsibility for managing the risks and costs associated with health care.
You Can Only Manage What You Measure
While we administer claims and manage care in a highly professional and accurate manner, the keys to improving the health of a covered group and the financial performance of their plan lie in putting information to work for our clients. Some of the questions we ask are as follows…How do we use the data we capture? What does it help our clients accomplish? Here are just a few of the ways data analysis can make a difference…
Understand the status of your covered group
Reviewing your existing plan design and recent claims history will help us understand the factors driving your costs higher. Individual health risk assessments can also be used to develop a more accurate profile of your covered population.
Identify and mitigate healthcare risk
Reviewing claims activity and the current status of covered members will enable us to identify those with chronic health conditions and the additional health risks facing your plan in the future. Once health risks are identified, a number of different strategies can be taken to minimize or transfer these risks.
Implement changes in plan design
The greatest advantage that self-funding offers is the ability to make changes in cost sharing parameters or benefits. Health and disease management, healthcare coaching and wellness programs can be added going forward, along with appropriate incentives.
Provide appropriate care for those with chronic conditions
One of the most important actions that can be taken is to make sure that those with chronic health conditions are receiving the care they need. Identifying these cases and addressing their needs in the most appropriate manner is critical to controlling costs.
Encourage participation in health management programs
At CBG, we work with our TPA partners and offer a comprehensive range of health and disease management programs. Implementing the appropriate strategies will help modify behavior, improve outcomes and eliminate spikes in future cost curves.