Next-generation employer group reporting: A health plan success story

From its roots in a University of Buffalo graduate school project to its unique preventive care model, Independent Health Inc. has always taken an innovative approach to its role as a provider of health plans to approximately 380,000 residents of western New York.

With a mission of improving members’ health and well-being with high-quality, affordable healthcare, the organization, founded in 1980, partners with area fitness, health and wellness organizations, promotes and provides a long list of free preventive care services, and is always looking for ways to do more and improve.

When Milliman MedInsight introduced Employer Group Insights (EGI) in 2022, Independent Health, a Milliman MedInsight client of 25+ years, was first in line to license the new product.

Independent Health’s reporting needs had grown increasingly complex. Employer groups that had fully insured medical coverage, self-funded pharmacy coverage, and custom claim administration practices that deviated from standard service definitions were quickly deteriorating the value of their standard reports. The legacy solution was simply not meeting their needs. The self-service access to brokers was cumbersome to support and limited both in the data available and its reporting capabilities. Independent Health’s data experts had to devote significant time to ad hoc reporting requests from brokers, limiting the amount of time they could devote to more strategic projects.

Action: Implementation of EGI by Milliman MedInsight, streamlining robust employer group data into tailored content

Milliman MedInsight developed EGI with the aim of helping health plans and brokers quickly and easily access the metrics they need to assess health plan performance, while also enabling a level of internal drill-down that could provide insights into plan efficiency and opportunities for cost savings and more effective utilization.

“The tool is one thing but having that relationship and working with the right people, I think is something that cannot be replicated. They have done wonders for us.”

Chris Arnold, Independent Health Director of Sales and Analytics

EGI enables users to analyze, report, and share key metrics of health plan performance, streamlining a robust data mart into tailored content packaged for individual brokers or employee groups.

For health plans like Independent Health, that means instead of creating dozens of ad hoc reports for brokers around pregnancy care, or Emergency Department use, or high-cost claimant data, they can provide brokers with secure access to their EGI platform instead, where brokers can easily access reports highlighting key metrics of health plan performance, and produce custom reporting in a single dynamic platform that can:

• Identify opportunities for efficiency and care improvement
• Transform complex data into custom storyboards that demonstrate plan value
• Identify services that drive per member per month (PMPM) costs
• Drill down into specific costs and special topics. E.g. How much of high-cost claimant cost is driven by pharmacy?
• Provide access to live data during client conversations for on-the-spot answers
• Quickly generate custom comparison reports within a population to identify potential opportunities for intervention
• Set up a curated client report with customized distribution and scheduling
• Track key indicators of client performance to identify emerging clinical cohorts or utilization patterns

Results: Happy brokers and time savings leveraged for deeper insights around pharmacy and high-cost claimant costs

The feedback from brokers came quickly: They loved it.

“I wish we saw this level of reporting (across) the country,” said one. Other brokers praised the system so much that a subsidiary third-party administrator asked for a demo and information on how they could license it as well.

Brokers liked the tool’s focus on visual storytelling, with a wide assortment of dashboards, charts, graphs and images that create a custom narrative around the data, but also enable a deeper dive into the details.

Among the most valued use cases for EGI among brokers, Director of Sales Analytics Chris Arnold said, is high-cost claimant tracking.

“You are able to get down to a whole level of detail that you were not able to before, to be able to see what is driving your costs in that population. You can see exactly where it goes.”

Chris Arnold, Independent Health Director of Sales and Analytics

Brokers also cite EGI’s ability to drill down into pharmacy costs, with breakdowns by branded and generic drugs as a key benefit, Arnold said.

With information at their fingertips, brokers no longer submit last-minute requests to run reports needed for meetings with their employer group clients. Brokers can use the curated custom storyboards and answer client questions on the spot.

Account managers also use the tool to track plan performance by employer group and to address issues that come up during renewal periods. What is driving costs? What changes and improvements can be proposed?

For the data and analytics team at Independent Health it has been a time saver and more: it is time they have leveraged to tackle more strategic queries and insights into how they can continue to improve plan performance and the care experience for their members.

When Independent Health does get queries from brokers now, it is for reporting at a level of detail and customization that drives innovation and insights. For more standard reporting, the brokers do not have to make a formal request and wait for a report. They can simply pull it up themselves directly in EGI from their desks.

“EGI brought forth a whole spectrum of new information that was not available on the legacy tool, including new filters and variables. With the EGI application, you have a whole litany of reports that you can get information on … things the market was asking about,” said Arnold.

“To be able to provide that information to someone sitting at their desk and getting it when they want it, that allows the informatics and sales analytics teams to do more detailed strategic reporting. We know that the number of ad hoc reporting requests was greatly reduced.”

Looking ahead

While the impact has been positive and the feedback from brokers has been enthusiastic, the Independent Health team is just getting started. They expect EGI to yield ongoing improvements, time savings and innovations including additional reports, details and capabilities powered by the Milliman industry expertise that they count on to keep them ahead of the curve.

Independent Health’s Employer Group Reporting Manager Nicole Ehrle said collaboration with Milliman MedInsight is an ongoing source of new ideas. “That’s one of the collaborations I love with this tool – having other ideas come your way,” she said. “Their understanding of what we were looking for right at the start really helped the whole project run smoothly,” she said. “We were always on the same page.”

Arnold agreed, citing Independent Health’s 25+ years of partnering with Milliman and Milliman MedInsight as a factor in the success of the organization’s EGI’s rollout. “I would absolutely recommend working with Milliman to anybody that asks,” Arnold said.

“The tool is one thing but having that relationship and working with the right people, I think is something that cannot be replicated. They have done wonders for us.”

About Independent Health

As a local health plan committed to improving the health and well-being of its nearly 380,000 members across Western New York, Independent Health is recognized for its innovation and exceptional customer service, also known as the “RedShirt Treatment®.”

In 2024, Independent Health was one of only three commercial health plans in the U.S. to earn a 5-star rating from the National Committee for Quality Assurance (NCQA).

Learn more: www.independenthealth.com/home

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