Do You (Really) Know What’s Driving Your Health Care Costs?
Five Questions About Population Health Analytics Consulting
Q: What is population health analytics?
A: Population health focuses on improving the health outcomes of large, defined groups of individuals such as Medicare beneficiaries or active employees or people living within a defined geographic area. Population health analytics looks at a variety of health-related data for a group to identify things like their health risks, medication adherence, care utilization patterns, and predicted cost and utilization risks.
Q: Does population health analytics help me improve the health of my employees or plan members?
A: It does. Population Health Analytics can help you understand the distribution of your current and predicted medical and pharmacy costs across your insured population. It can identify the biggest cost drivers and determine the largest opportunities for impacting health care costs and improving your employees’ or plan members’ health outcomes. For example, an analysis of your workforce—or a segment of them—might indicate that they are at-risk for developing diabetes. Knowing this, an employer can more confidently allocate resources for a pre-diabetes intervention program that best addresses this risk. Analytics tools also can be used to measure the outcomes of the intervention to evaluate its effectiveness over time in both improving health and managing related health care costs.
Q:Is this type of analysis different from what I get from my benefits consultant, carrier or a third-party administrator (TPA)?
A: Benefits Consultants, carriers TPAs typically provide an analysis of your employee and plan members’ highest cost claims and patterns of utilization which is useful to understand the financial risks and develop plan design strategies to mitigate health plan cost increases. To understand what programs and interventions to put in place and which of these will have the highest impact, it is important to also analyze the clinical risks and more importantly, which of these are impactable. For example, many times an individual may have pre-diabetes as identified by a carrier’s analytic report and the individual is immediately asked to enroll in a diabetes prevention program. Using the ACG System to identify all diseases associated with an individual, both acute and chronic , we may find mental health issues and poor medication compliance are causing that individual to develop complications associated with their pre-diabetes diagnosis., meaning that a As such, a more tailored treatment plan will likely be more cost effective to the employer and result in a more successful outcomes for the individual. . . This presents an opportunity to intervene with a mental health intervention first to ensure the individual is in the right frame of mind and staying compliant with their medications prior to engaging them in a diabetes prevention program to prevent rising risk and health care costs.
Q: Does Johns Hopkins do population health analytics consulting for self-insured employers?
A: We do. Typically partnering with the client and their benefits consultant, we use the Johns Hopkins ACG System, our proprietary population health analytics tool, to provide a clinical and financial analysis of a population. One reason the ACG System has been so effective and, therefore, so valuable to employers, health plans, governments and providers is because we take a whole-person approach to our analysis. Most other analyses tend to focus on one specific disease or episode of care. We collect data on all conditions, all medications and lab result data associated with an individual that may be impacting her/his health status and care utilization. Our clinically-validated approach can help inform which interventions, programs or benefit design packages will be most effective to implement for your employees or plan participants.
Q: What’s involved in the Johns Hopkins population health analytics consultation?
A: Before conducting the analysis, our population health experts will spend time with you to understand your existing health and well-being programs and benefit design. We want to know things like your top health-related concerns and priorities and what has been effective to date in improving your population’s health. We will engage you throughout the analysis to validate the results. After the analysis, our experts will provide a comprehensive, easy-to-digest report to you and your leadership team and discuss the insights we gleaned from our analysis. The Johns Hopkins population health team will highlight to you the actions and interventions that, in their experience, are likely to have the greatest impact on your most pressing health care concerns, from chronic condition management programs to guiding you through how to tackle questions related to changes in benefit or network design.