Ahem…healthcare open enrollment is almost upon us again. At this point you are likely tying down loose ends and focusing on your key messaging and engagement strategies for your employees. It’s always a heavy lift and hard work. I know from past experiences the exhale that comes when you reach this point and milestone.
I don’t envy you and this journey every year. Costs in 2024 increased by more than 8% on average and that number is predicted to be the same or even higher for 2025. I have heard some state employer plans are predicting premium increases north of 25%! There is a clear affordability crisis for employers, their workers and families.
New transparency disclosure laws and regulations require employers to have available shoppable information on how costs for covered health care services and drugs are determined so they are able to compare and seek the best value for health care going forward. It’s a bit overwhelming, especially since the information in healthcare and from your health plans and providers remains a mess. Despite the new laws and regulations giving you much greater access to your information than ever before, those you trust with that information still don’t want you to have easy access to it.
You are not alone if you wonder: Do I really have the unbiased and arms-length tools I need to navigate and manage the complexity of today’s system (especially given these known new legal risks and the shifting fiduciary landscape)?
For many the answer to that question is no. However, the solution is frankly easier than it seems: the key to managing all this complexity starts and ends with information. To riff on a phrase I learned from James Carville, “It’s the data, stupid!” When it comes to the health and wellbeing of your employees and their families, you can’t afford to make decisions on bad, conflicted or incomplete data.
Fixing health benefits starts and ends with your data, and you can blaze new trails on behalf of your employees and your company by gaining clarity through data so you can focus on tested and proven strategies that deliver high-performing benefit plans.
A new blueprint for action won’t be easy, but that’s where 4C Digital Health can help. You need a solid foundation of unbiased data that tells your story, and we have a robust data infrastructure and suite of solutions to help you turn your data insights into action. It has to be complete, timely and should even be standardized. It must include:
Financial data … and not just claims information but also invoice and payments tied to medical and pharmacy that interprets historical data while allowing you to diagnose the root causes of any problems;
Operational data … including case status and outcomes that’s connected to individual employees and family members;
Clinical data … this should include health records, lab work and other data tied to a person’s health condition(s).
In today’s environment, employers should be managing their health plans with the same fervor and enthusiasm as they do with any other facet of their business or part of their supply chain. Employers need to develop and thoroughly document processes for evaluating performance of their plans, point solutions, consultants and other health plan advisors. It is important – and the law – to regularly review fees, claims and other compensation and benchmark to ensure costs are reasonable in the marketplace.
Get started today and get a better pulse on how your benefits are performing. Don’t wait for another open enrollment season to pass you by. Act today!
Written by:
Alan Gilbert
SVP Business Strategy
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