Follow the Money: Connecting Employee Income and Health Plan Costs

Sep 30, 2016 | Commentary

Many benefits managers are data-hungry. They know that intuition may lead to insight but also that probability and not mere possibility requires evidence. So, they pour over charts and tables from their TPAs, PBMs and advisors, looking for relationships between variables like health plan cost, usage, medical conditions, places of service and the differential effectiveness of providers. Often, the data analysis focuses on plan member cohorts: are our costs coming from one plant or division more than others? Is there a greater prevalence of chronic disease in certain geographical areas? Benefits managers are always trying to understand why things are the way they are, so that they can take action where it will have the greatest impact on cost and usage. In this search for meaningful correlations, there is good reason for benefits managers to use the old phrase, “follow the money,” in a way that most probably have not. (more…)

Outsourcing the Baby with the Bathwater?

Sep 7, 2016 | Commentary

“An outsourcing increase is a positive thing for benefits departments. Benefits staff are working smarter and more efficiently by choosing the mix of outsourcing, co-sourcing and insourcing that’s right for them. More benefits departments are adding staff members, creating balance and strategic focus among departments.”

 

Julie Stich
Research Director, CEBS
speaking at the International Foundation of Employee Benefits Plans

Benefits managers are inveterate trend watchers. How does this year’s trend in specialty drug costs project for next year? And we watch each other – is there any trend in the kinds of changes other benefits managers are making? For many of us, the worst kind of surprise is to be told of a new benefits trend from our boss rather than the other way around.

One of the trends in benefits that is capturing more benefits managers’ attention is outsourcing. For most benefit managers, outsourcing a significant portion of their department’s activities is not new. How long has it been since we outsourced the claims administration of our medical plans? (more…)