Mitigating Health Plan Risks to Promote Positive Change
Through service to hundreds of large employer clients with generationally and geographically diverse employees, CBIZ provides a comprehensive understanding of how changing medical marketplace offerings can accommodate the unique needs of your organization.
As a top 25 broker of U.S. business, CBIZ offers large employers the combined power of multi-disciplined expertise and advanced data analytics. Through the knowledge provided by our unified pharmacy, wellbeing, actuarial and clinical consulting experts, the Health Innovations Practice (HIP) offers organizations insight into healthcare purchasing strategies that lower medical and pharmacy costs, improve the patient experience and create a competitive advantage for recruitment by offering affordable and attractive benefit plans.
Process-Oriented & Evidence-Based Strategies
CBIZ adheres to a process that focuses on three steps in the strategic cycle: identify, act and measure.
Step #1: Identify
Through CBIZ’s robust data insights, the Health Innovations Practice identifies health care cost drivers and employee engagement opportunities, isolates areas of fraud, waste and abuse and utilizes cost and medical quality performance to curate proper strategy. In addition to claims data, CBIZ’s ability to benchmark quantitative aspects of health plan financing such as contribution models and specific categorical health plan spend are supported by our industry-focused, but operationally diverse client base.
Through the combination of interpreting big data and analyzing competitive intelligence, CBIZ creates custom reports and meaningful insights that lead to action on how to tailor benefits and consider strategies that meet your organization’s and employees’ needs.
Step #2: Act
After data is properly interpreted, CBIZ evaluates all possible means to define a multi-year strategy that not only meets client objectives, but also improves cost, quality of care and the employee experience. Through our experience in population health, epidemiology, pharmacy consulting, wellbeing and actuarial services, the Health Innovations Practice of CBIZ curates strategies that are inclusive of:
- Network analysis
- Funding mechanisms
- Referenced-based pricing
- Direct contracting
- Higher performance networks
- Centers of excellence
- Pharmacy coalitions
- Rx advocacy
- Condition-specific strategies such as fertility or dialysis
- Worksite clinics or direct primary care
Step #3: Measure
Once a strategy is deployed, CBIZ reaffirms the effectiveness of the strategy by measuring the effects of each individual component by using our data insights. Are key benchmarks being met? Is the client paying less for healthcare? Are employees going to the best quality hospitals for care? Are clinical compliance rates improving for members who have costly chronic diseases? Are the vendors being used doing an effective job as intended? As these variables are being solved for, what new challenges arise?
This cyclical process of identify, act and measure allows CBIZ to properly develop and validate that the insights and recommendations have a definitive impact on your organization’s ability to offer competitive and cost-effective benefits.