Four Questions for The Whyzen Team at Health Intelligence Company on Solving the Rubix Cube of Health Plan Benefit Design with Analytics

By Claire Thayer

Drs Mary Henderson and Russell Robbins from The Whyzen Team at Health Intelligence Company participated in a Healthcare Web Summit webinar: Solving the Rubix Cube of Health Plan Benefit Design with Analytics.  The discussion highlighted the greater need for near real-time, population-specific health benefits analytics.  The speakers addressed how Whyzen is helping health benefits stakeholders spot outliers and track variations from benchmarks over time with quick views of cost, quality, and utilization.

Additionally, with COVID-19 being top of mind for so many, Whyzen has added reporting capabilities that allow health plans, employers, brokers/consultants identify who and where their most vulnerable employees/members are. This targeted information empowers all users to better allocate care management resources for targeted and impactful interventions.

If you missed this engaging webinar presentation, you’ll want to be sure to watch the Webinar Video. After the webinar, we interviewed the speakers on four key takeaways: 

1. What are some of the ways that employers are mitigating out-of-network costs?

The Whyzen Team at HIC: While out-of-network costs are not the biggest driver of healthcare trends, they are definitely substantial – and largely avoidable. Employers are looking for solid data to provide support for alternatives and programs that comprise key elements of benefit design. Whyzen provides the analysis and justification for appropriate programs.

For starters, employers need to assess the extent to which out-of-network costs drive overall trends. Whyzen – from Health Intelligence Company (HIC) – can help them quantify the scope of the problem and identify where the saving opportunities lie.

For example, for elective surgeries (e.g., bariatric surgery, orthopedic surgery), Whyzen can identify the types of procedures that were performed, the volume of procedures, and whether they were done in or out of network. To avoid high rates charged by out-of-network providers, Whyzen enables employers to guide employees to Centers of Excellence or to align patients’ needs with more appropriate sites of service.

2. You mention that employers are telling you that only "data nerds" can get value out of reporting and analytics solutions. Can you tell us more?

The Whyzen Team at HIC: Frequently, companies that use analytics solutions find them to be cumbersome to navigate, time-consuming  to get to a decision point, and lacking  actionable recommendations at the end of the analysis. As a result, plans, employers, and brokers tend to hand that work off to data experts, thereby distancing their clinical, care management, and benefit design staff from data-driven insights. And data analysts may not understand the clinical, quality, or financial implications of their findings.

Solutions that are accessible, intuitive, and inclusive of many data sources allow users to spend less time analyzing and more time developing strategies and interventions. Health Intelligence Company designed its Whyzen employer reporting solution with those features in mind.

3. How does Whyzen differentiate itself from competing solutions? What are its key strengths and differentiators?

The Whyzen Team at HIC: Whyzen stands out as the industry leader for employer reporting and analytics for a number of reasons:

•    Standard and Customized Reporting:
•    Interactivity
•    National Benchmarks
•    Flexible Analytics
•    Deep External Data Integration
•    Flexibility / User Configurability

4. What types of  benchmarks can Whyzen produce?

The Whyzen Team at HIC: Whyzen utilizes HIC’s National Benchmarking Module (NBM) to provide a rich set of benchmarks. HIC draws on a dataset that contains over 200 million unique lives and over 20 billion healthcare claims. Employers, brokers, and third-party administrators can compare relevant, HIPAA-compliant healthcare performance metrics. Whyzen can examine and compare cost and utilization performance by: 

Geography

•          National vs. regional vs. local
•          Census region and division
•          Region type (urban, suburban, rural, exurban, etc.)
•          State, city, or ZIP Code

Industry

•          Industry category
•          Standard Industrial Classification (SIC) codes

Product

•          Preferred Provider Organization (PPO)
•          Health Maintenance Organization (HMO)

Account Size

•          Small
•          Mid-Market
•          Large

By viewing data through geographic, industry, product, and account size lenses, users can easily:

•          Compare employer accounts
•          Drill into cost and utilization data
•          Explore quality measures, health risk scores, and clinical episode components

HIC’s unmatched data set and rigorous analytic model offer customers the single best view into how their spending compares on any number of dimensions.

For more information on Whyzen or Health Intelligence Company – or to view our recent webinar, “Solving the Rubix Cube of Employee Benefit Design” – click here.