CHALLENGE

Sheer Quantity of Data is Overwhelming

Iredell Health System is a non-profit healthcare system with over 1,000 employees and 250 physicians. They offer high-quality healthcare and wellness services and boast a long list of awards and accolades for serving their local community through educational programming,   charity care, and innovative medical technologies.

After seeing an increase in employee medical costs over the years, this healthcare system was looking to reduce dollars spent on their insurance claims. They challenged their broker to find an effective way to identify the factors driving up their cost. The sheer quantity of data can be overwhelming along with the manual process of manipulating the data in spreadsheets. Trying to manage this process manually was a significant challenge.

 

SOLUTION

The Game-Changer for Insurance Brokers

The Health System needed a tool to help them see where their healthcare dollars were being spent. By utilizing NavMD's claims data analytics system, they were able to understand the conditions along with the exact types of services and procedures that were increasing their costs. The broker was able to use this information to help create a more effective plan design for their medical benefits and was also able to create a multi-plan design to encourage in-network utilization, as well as domestic utilization to the hospital. The data was also a great supplement to the client’s newly revived Employee Wellness program. After reviewing claims data, pinpointing what health conditions were most prevalent and costing the most money, the group designed a targeted wellness program around certain health conditions.

RESULT

The Insurance Broker Delivers & Creates a Loyal Customer

Because of the clear insights, they built a targeted wellness program with an 80% participation rate – that is over 900 employees participating. The program has been successful in reducing tobacco use, body mass index, LDL, and blood pressure across their employee population. Through creative plan design and strategy, the Health System saw a 14% decrease in claims and over $1 million dollars in savings. Calculated risk for employee population dropped 4%.

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