What to measure
Evidence before assumptions.
- Complete claims access
- Recurring performance reporting
- Identified cost drivers
- Vendor data rights
← The Framework
Component 02
Data, Analytics & Transparency
Do we actually know where our healthcare dollars are going?
Clear definition
Data, analytics and transparency create the visibility employers need to understand claims, prices, utilization, vendor performance and the drivers behind a plan’s financial results.
Common mistakes
What weakens performance.
- Relying on renewal spreadsheets and loss ratios alone
- Accepting incomplete vendor reporting
- Collecting data without a decision process
High-performance practices
Build a deliberate approach.
01
Establish year-round medical and pharmacy reporting
02
Trace spend by condition, provider, site of care and service
03
Put data ownership and access requirements in vendor agreements
Book connection
Chapter 17: Seeing the economics
Chapter 17 and related chapters
The transparency chapter gives leaders a way to move from carrier summaries toward decision-ready claims and vendor data.
Explore the bookHealth Plan Score connection
Data, Analytics & Transparency
Can the plan team identify the main cost, utilization and performance drivers with complete, recurring data?
A lower score points to data-rights, reporting cadence and a defined process for acting on what the data reveals.
Take the Health Plan ScoreEmployer Benefits IQ resource
Health Plan Data Checklist
A printable Employer Benefits IQ worksheet for defining the decision, evidence, accountable owner and review cadence.
Author perspective
By Corry Hull, REBC, CSFS — Author, The High Performance Health Plan and Founder, Employer Benefits IQ.
Explore the Health Plan Score