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So What? Translating Data and

Jargon Into Action

Lizann Reitmeier, CEBS Canadian Health Practice Leader

BuckToronto, Ontario

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Background

• Lizann Reitmeier, Health Practice Leader, Conduent Human Resource Services

• A few years of experience in the business• 2 insurance companies, mostly consulting• Story teller, superhero

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Caution!!

• Sweeping generalizations ahead!• Please don’t be offended . . .

– Especially if you are male, over age 40 . . .

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We Don’t All Speak the Same Language

• Did you just say STD?• Copay or a coinsurance• Generic or SEB• 1 3 Lingual• Is that aggressive or conservative

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Say What You Mean

• STD/WI• Cost of Capital/Profit charge• Utilization/Trend/Inflation• Be clear• Ensure the Listener Understands• Overshare• Be transparent

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Big Data!

• Data is the new currency• Computers can track and store and cross

reference• Full personal profile• Your cell phone knows more about you than

your doctor!

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And Too Many Silos

• Privacy protection limits consolidation• Reported in fragments—applied in fragments• The employee population reflects the plan

experience and vice versa• The life demographics provide insight into the

potential plan experience• The health claims reflect the potential disability

claims

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Example 1—Life Demographics

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Example 1b—Life Demographics

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Interpretation

• Group heavily male• Almost evenly spread over Boomer, Gen X, Y• Risk growing at older ages, reflecting higher number of

employees working beyond 65• Risk declined at younger ages due to lower coverage

amounts (earnings)• Growth in group at younger ages not quite offsetting

aging• Rate increasing reflecting risk

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Example 2—Drug Analysis

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Example 2b—Drug Analysis

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Interpretation

• Top 10 drugs by dollar amount account for almost 19% of claims

• Serious medical conditions in the population• Potential for disability claims to be avoided• About 24% of these claims for drugs due to

modifiable illness—Type 2 Diabetes

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A Lot of Insight

• A lot of information in a few slides• Average age/Age distribution• Gender composition• Medical conditions• Family status (not on these slides)• Province of residence (not on these slides)• What more do you need?

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Benefit Plan Strategy

• A significant component of compensation• Should reflect corporate goals, risk tolerance• Treat all employees the same?• Pay the most in the market?• Attract and retain—who?• Unlimited cost and unrestrained increases?• Who pays how?

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Apply What You Know

• Fit of current plan design– Adequate for employees’ needs?– Attractive to new hires?

• Cost of current plan? Sustainable for future? • Employee satisfaction?• Communication of Plan?• Risk mitigation appropriate? (Underwriting methodology,

pooling level)• Are we aligned with strategy?

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Modify to Fit

• Plan redesigns are time consuming and may send a negative message

• Small changes may be a transition to a better plan/better fit

• May be easier to implement in a union environment (caution)

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Example Strategy Alignment

• Employer (not unionized) with our sample demographics and claims assesses current plan (majority male over age 40)

• Strategy includes supporting employee health—physical, mental and financial

• Sustainable cost a principle of strategy• Type 2 Diabetes major cost driver• Gaps exist between plan and strategy• Next steps?

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Reaction 1—Diabetes Management

• Research supports intervention can favorably impact Type 2 Diabetes

• Type 2 Diabetes costing employer $17,000 annually in drugs alone, additional cost for absence

• Targeted interventions can impact employee health and cost

• Insurers and pharmacies are implementing programs encouraging compliance with medication at little or no cost to plan sponsor

• Reduced waste = Reduced cost

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Reaction 2—Wellness

• Wellness part of a big picture• Should be part of the benefit strategy• Opportunity to impact employees/families• Knowledge is power• Limited need for incentives• Reduced waist = Reduced cost

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Reaction 3—Voluntary Critical Illness

• New benefit for employees• No additional cost to employer• Financial support in event of catastrophic

diagnosis• Communication opportunity• Favorable employee reaction to roll out and to

claims paid

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Reaction 4—Communication and Engagement

• Employees perceive a well-communicated plan to be better

• Employees more engaged when benefits are communicated

• Be inclusive, reflecting multi generational population• Rely on various media• Encourage long term health—see Dr., get flu shots, use

EAP etc.• More engagement = More profit, retention

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Key Takeaways

• Lots of data available in insurer reports• Translation may be required for full picture• Know your audience• Small actions may have big results (Increase

ownership of health, ROI of One)• Appreciation of benefit plan• Appreciation of employer• Engagement

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