Optimizing self-funded health benefits strategy with advanced analytics
Here’s how one client leveraged Milliman DEPTH to inform its cost management approach. The client sponsors a self-funded health plan offering medical and pharmacy coverage to nearly 90,000 members across several states. It wanted answers to these key strategic questions:
- How efficiently is the plan performing currently?
- In what ways is the plan already achieving cost savings?
- Where can efforts be focused to reduce healthcare costs while improving member benefits and experience?
Milliman consultants interviewed key plan leaders, collected patient-level and service-level medical and pharmacy claims data, and used the DEPTH tool to assess the client’s performance across specific plan and population cross-sections as well as in aggregate. Plan performance was measured using an efficiency index approach for three categories: total cost of care, utilization, and unit price.
Savings opportunities for improved care management
Chronic condition | % Members | Total plan savings |
---|---|---|
Cardiovascular | 15% | 4.25%-8.50% |
Behavioral health | 18% | 2.50%-4.00% |
Actual plan results were compared to benchmark intervals to identify not just areas for improvement, but also to determine areas of success for the plan. It is crucial for plan leadership to know what has worked well so that those approaches can be continued in the future.
Leveraging nearly 1,000 plan and population cross-sections to uncover critically important performance drivers, Milliman DEPTH was able to identify the largest savings opportunities for the plan. Based on these results, Milliman consultants produced key strategic insights and recommended action items corresponding to each insight.
About the Author(s)
Optimizing self-funded health benefits strategy with advanced analytics
Milliman DEPTH is a data-driven and visually dynamic tool that transforms medical and prescription drug claims data into actionable insights accessible via a user-friendly dashboard.