Understanding how new analytics can help employers manage risk.

Employee benefits managers get most of their relevant information about employees and their dependents from claims data submitted by clinicians, hospitals and other healthcare providers. Each claim logged includes diagnoses, treatment codes, fees and demographic information. A single illness or injury may generate dozens of claims.

The sheer scale and speed of the collected data can be overwhelming. And, in many cases the employee benefits managers don’t have direct access to the data, nor know how to interpret it.

When it comes to using the available data to make smarter business decisions, employee benefits managers have a challenge on their hands.

  • How do they sift through lines of the claims data to spot trends?
  • How can they paint a picture of those trends?
  • How can insights gained from the data inspire actions the business can take to mitigate risk?
  • How can they accomplish the above more efficiently, so they can spend less time wrangling data and more time making meaningful changes for employees where it matters most?

Data visualization offers the potential to help solve these challenges. Using data visualization, the numbers are aggregated, analyzed and dynamically presented as new information comes into the system to create illustrated graphs, charts and other representations. At a glance, decision-makers are better able to ascertain what stories the data tell.

Newly available visualization tools give employers a dynamic line of sight into:

  • Usage, costs and other factors that drive employee benefit expenses
  • Risks and needs within their organizations
  • Better ways to manage their programs – whether that means making plan design changes to save money or creating new resources to better serve the unique needs of the employee base

Painting the Picture

Tools like Tableau – an industry-leading business intelligence software solution used by M&T Insurance Agency (MTIA) – enable teams to create interactive dashboards that monitor healthcare trends based on claims data. This allows for real-time alerts, analysis and feedback on programs and plans. The tools also help differentiate outlier issues from trends that warrant further investigation and potential action, such as clinical service utilization changes or moves toward more costly medications.

Via interactive dashboards, data visualization brings to life workforce trends such as an increased prevalence of diabetes among employees. This can empower an employer to change its plan design and/or wellness programs to help modify behavior in their population — exercise and diet, for example — and help avoid greater consequences in the future.

These dashboards can also show trends among employees’ dependents, who may have different patterns than employees and whom the employer may never interact with. Both populations can benefit from communications and wellness programs tailored to address these satellite concerns. If, for instance, analyses show high incidence of high blood pressure, diabetes or other issues among a population, communications resources can be designed to help these people find professionals and facilities where they can receive the treatment they need.

Mitigating Risk

Business owners, human resources directors and benefits managers using visualization tools can gain an advantage when it comes to identifying patterns. This early warning system means better cost management and increased employee satisfaction.

  • Cost Management. Employers who self-fund benefits can adjust plan design to better manage conditions that are prevalent among the participant population. They can change cost share to make it more advantageous for employees to follow treatment plans. In addition, they can provide incentives and information to encourage individuals to use nurse hotlines and seek treatment from primary care physicians and walk-in clinics rather than costly emergency rooms
  • Increased Employee Satisfaction. An employer can also examine compliance data among the at-risk population, such as how well they follow treatment plans and take prescription medications. This gives the employer better intelligence on ways to tailor benefits communications and wellness programs that will truly help plan participants. Staying true to the trends and focusing on specific support tools to help makes it easier for employees to see the employer as a partner that wants the best for its people

A Look Ahead at Employee Benefits

As more benefits managers look for partners to help them make sense of their data and mitigate risks, interest is also growing in predictive analytics. New tools enable plan participants to have access to their health information and utilize it to manage their health and the cost of their healthcare.

Predictive analytics capabilities now in development will empower employers to anticipate future trends and respond proactively. For example, an employer could see predicted outcomes as soon as a trigger occurs (e.g., a participant submits a claim for a particular condition) and provide information on treatment options and care providers.

In the next phase of employee benefits, predictive tools with visualization and color coding – thanks to widespread adoption of smart phones and other personal information technology – may also be used by individual employees to manage health, make healthier lifestyle choices and enjoy better outcomes when they require treatment. If they can see personal health information visualized through these tools, numbers such as blood pressure and cholesterol scores become more meaningful. The future of these tools includes increased engagement through gamification (e.g. similar to how they use of Fitbits and Apple Watches to monitor daily activity and heart rates and compete with friends and coworkers).

The teamwork between benefits managers and their impacted employees is only becoming stronger as these new resources continue to develop. Organizations that continue to invest in these types of solutions have an opportunity to not only better engage their employees, but also to gain a competitive advantage in how they design and manage benefits programs to make them more cost-efficient and effective over the long term.

Want to Learn More?

Stay ahead of the trends with M&T Insurance Agency’s Employee Benefits Team.

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This article is for informational purposes only. It is not designed or intended to provide financial, tax, legal, investment, accounting, or other professional advice since such advice always requires consideration of individual circumstances. Please consult with the professionals of your choice to discuss your situation.

Insurance Products offered are: Not FDIC insured; Not a deposit in, obligation of, nor insured by any federal government agency; Not guaranteed or underwritten by the bank; Not a condition to the provisions or terms of any banking service or activity

Insurance products are offered by M&T Insurance Agency, Inc., not by M&T Bank. Insurance policies are obligations of the insurers that issue the policies.


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