Keeping Score: Annual Claims per Employee

Keeping Score: Annual Claims per Employee

Knowing your organization’s number of annual claims per employee is an important piece in understanding its medical cost drivers.

When viewed in conjunction with cost per claim, you can quickly assess if an upward surge in medical claims per employee is due to increased utilization, rising cost of claims, or both. Once that’s determined, you can more effectively address the associated cost drivers.

Let us know if you would like to learn more about how to improve your score in this area. (more…)

Keeping Score: What’s Your Rx Spend PMPY?

Keeping Score: What’s Your Rx Spend PMPY?

Prescription drugs can be difficult to manage in a plan, especially if you don’t have a good grasp of all the related metrics.

  • Do you know what you’re spending on every member in a year?
  • How do your Rx numbers compare to our database?
  • Do you know what’s causing the changes in your drug costs year-to-year?

There are several strategies and tools employers can deploy to mitigate rising prescription drug costs. But first you need to track these numbers to get at the root cause.

Let us know if you would like to learn more about how to improve your score in this area.
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Keeping Score: Know Your Net Cost

Keeping Score: Know Your Net Cost

Most employers benchmark their gross health plan cost on a per employee per year basis. The net amount employers pay (gross health plan costs minus employee payroll contributions) is also an important measure to track in support of sound plan management. As you can see, the amount can vary from one employer to another by thousands of dollars per employee.

Where do you fall in the range above? Knowing how that number matches up against your budget, benchmark, and last year should be a priority. It goes without saying that having answers to questions like this at your fingertips enables you to better manage your plan.

Let us know if you would like to learn more about answering this question, tracking your numbers, and better managing your plan.
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Keeping Score: Ouch! Average Cost per Specialty Drug Script

Keeping Score: Ouch! Average Cost per Specialty Drug Script

Specialty drugs can carry hefty price tags. Our data shows companies see an average specialty drug cost per script of over $5,000 — with that number more than doubling for some. This high per drug cost demonstrates how just a few specialty prescriptions can have a dramatic impact on your plan.

Fortunately, there are several strategies employers can deploy to mitigate rapidly increasing specialty drug costs.
 
How do your plan results compare? Let us know if you would like to learn more about how to improve your score in this area.
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Keeping Score: Read This in Case of Emergency

Keeping Score: Read This in Case of Emergency

Emergency room visits can quickly add significant dollars to a plan spend and result in unnecessary or inappropriate care to members. Knowing how you’re performing in this area is essential to good plan management.

Studies have shown that up to 70% of emergency room visits are not for the treatment of true emergencies. At an added cost of $1,000 or so per visit, employers may be overspending up to $150 per plan member per year on unnecessary ER services.

How do your plan results compare? Let us know if you would like to learn more about how to improve your score in this area.
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Keeping Score: How does your specialty drug spend stack up?

Keeping Score: How does your specialty drug spend stack up?

Specialty drugs have quickly become a significant portion of drug benefit spend. This is driven by less than 1% of claimants and calls for very specific and active management.
 
Although not nearly as visible, comparable amounts are being spent within medical benefit programs. Fortunately, there are several strategies that employers can deploy to mitigate rapidly increasing specialty drug costs.
 
How do your plan results compare? Let us know if you would like to learn more about how to improve your score in this area.
 
*From Chelko Consulting Group’s proprietary database of employer results. (more…)