A recent New York Times article by Robert Pear took a look at a leading healthcare company, Geisinger Health Plan, and covered the current state of the healthcare benefit market. 

Early in the article, Pear quotes Kurt Wrobel, Geisinger’s Chief Actuary:

“Historical experience is the lifeblood of what we do,” Wrobel said. “We take that experience, adjust it for the underlying growth of health costs and project it into the future so we can estimate the expected costs for a particular insurance policy.”  

While Wrobel is speaking on the specifics of insurance and health plans, which Geisinger understands so well, his mention of “historical experience” brings up the idea of data – historical and current – and the question of what exactly health plans (such as employer health plans) should be doing with the data they generate so they can benefit from their historical experience.  

Much of the relevant healthcare data – claims data, for example – is stored by external vendors all across the country. However, as there are no defined and accepted data standards, nor data models, this data is not integrated, allowing for few insights. The data is difficult to manage and if a plan wants to change a vendor, it can be expensive or impractical.

DHS Group believes that a plan (or employer) should keep and manage all their health data independent from vendors like carriers and TPAs that help them collect and manage their benefit and wellness programs.

Why should plans and employers manage and keep their own data?

  • When data resides at different vendor databases, it’s difficult to integrate or associate. Without integration and association, the ability to analyze the data and make decisions is time consuming and difficult. The more difficult the data is to analyze, the less of an opportunity to predict costs and then develop real solutions to improve health and lower costs.
  • In some cases, external vendors can go as far as “holding the data captive” from the plan owner to protect their “business,” by making the cost and time to switch vendors prohibitive.
  • When a plan has their data under their own control (i.e. vendor and data independent), the burden of changing for a specific situation is lifted and the provider is free to change to fit their own needs and wants.

It's pertinent for companies to keep a close eye on their data to control their own destiny – learning from the past in order to deal with the present and better predict their future.

After all, as Wrobel said later in his interview with the New York Times, “The whole point of what we do, the foundation of good health insurance, is to develop long-term relationships with our members and to make long-term investments in their health. It’s not like buying a book from Amazon.”


Click here to learn more about how DHS can help you learn from and control your data or schedule a personal demo below.