Data: A major challenge for employers

The major problem holding back employers: Data

June 07, 2021
Introducing CPR’s data series and other initiatives to support employer-purchasers in accessing the data they need for high-value health care purchasing.

As health care prices continue to rise, employers and other health care purchasers are seeking ways to stretch their health care dollars further. Employers’ interest is growing in high-performance provider networks, care navigation support for health plan members, and other data-driven strategies that help plan members access the providers offering the best combination of cost and quality.

But one major problem is holding back progress: many employers and other health care purchasers are struggling to get the data they need to understand what’s going on with their plan members and to support newer kinds of health benefits strategies. Instead of operating in a transparent arena with defined rules, employers and their contracted partners are struggling to determine who owns which data and how and when it can be shared to inform, operate, and evaluate health benefits programs.

Employer-led purchasing efforts from Haven Healthcare to Health Transformation Alliance (HTA) have all faced the data access challenge. A Fortune Magazine article published on June 1, 2021, quoted Robert Andrews, CEO of HTA, saying that “Getting data from insurance companies and PBMs is like trying to get raw meat from a caged lion.” But, does it have to be this way?

CPR is stepping up on behalf of the interests of our employer-purchaser member organizations and other purchasers to improve data sharing and transparency across all vendors working in the employer-sponsored coverage marketplace. We’ll define what purchasers need from the health care ecosystem, help them express those needs as they procure, contract with, and manage their health plan, vendor, and other data partners, and push the industry to uphold customer-centered practices. Activities will include forming a purchaser-only roundtable to dive into the issues and solutions; developing template RFP questions and model contract language; empowering benefit managers on the power of benefits data through an online course; and educating the broader public through a podcast series. Finally, we’ll host a virtual summit featuring industry thought leaders and employer-purchaser representatives who are actively working toward a more transparent and efficient benefits data ecosystem. This campaign builds on CPR’s previous work evaluating the data warehouse and analytics marketplace and fighting for health care price transparency.

With that background, we are thrilled to release two items today: Our new data series on the Listening In (With Permission) podcast and our new online education course, Getting to Insights Faster with Benefits Data.

The data series will share diverse perspectives on the role of data in health care and health benefits, including provider, purchaser, and academic voices. It will also feature industry leaders who have committed to amplifying the purchaser voice by sponsoring CPR’s culminating Virtual Summit or other CPR educational events. As always, CPR retains editorial independence of our podcast and the other outputs of our campaigns.

Listen to the inaugural episode in our data podcast series: Thi Montalvo, Health Analytics Practice Leader at Willis Towers Watson, on the challenges employers face in using their health care purchasing data

The Getting to Insights Faster online course, produced with support from the Peterson Center for Healthcare, provides an overview and case studies on how purchasers can use data effectively to improve the value of their health care dollars. The course covers how combining demographics and utilization data helps purchasers know where to focus their health benefits efforts; how to use data to address price inefficiencies; and how to mitigate common barriers to understanding how quality of care varies across local providers. HR staff who purchase health care on behalf of a population, as well as CPR member organizations, receive complimentary course registration – email connect@catalyze.org to get your discount code.

Explore the Benefits Data Online Course.

Feature image by MayoFi on Unsplash.

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