How Self-Funding Data Drives Employee Well-being

When employers choose to self-fund their health plan, they’re not just cutting costs, they’re unlocking data that can improve employee well-being and productivity. Self-funding data can open the door for targeted wellness programs, better care coordination, and measurably increased engagement.  

Keep reading to learn how you can unlock the full value of your data to increase employee well-being.  

Why Self-Funding Data Is Different

Compared to fully insured plans, self-funded plans give employers greater visibility and actionable insights. Here’s how they differ: 

Timeliness

Fully insured plans often provide delayed, high-level reports, sometimes only once a year, while self-funded plans offer regular, near-real-time updates.  

Detailed Insights

Self-funding data drills down into utilization by service category, condition, and site of care, instead of broad summaries. 

Integration

Employers can connect medical and pharmacy claims with eligibility information, biometrics, and engagement metrics for a complete picture of workforce health. 

Actionability

With faster, more detailed insights, employers can spot emerging trends early, see how interventions are working, and take proactive steps. 

The Data You Already Have (and Underuse)

Many employers underestimate the richness of the data they have. Here are the core datasets you can begin leveraging with self-funding: 

Medical claims

These reveal utilization patterns, like whether employees are choosing the emergency department over primary care or urgent care, how often imaging or elective surgeries occur, and the prevalence of chronic conditions. Medical claims can also show care gaps, like missed cancer screenings or unmanaged diabetes and highlight avoidable costs to employers.  

Pharmacy claims

Prescription data helps employers identify adherence patterns, specialty drug spend, opportunities for step therapy, and duplication of medications. Pharmacy claims data can also flag employees who may be at risk of poor outcomes due to skipped refills.  

Eligibility & demographics

Tenure, job type, location, and health plan type can all inform how employers communicate with their employees about their benefits. For instance, hourly workers on evening shifts may benefit from increased awareness of telehealth options, while long-tenured employees might respond better to wellness counseling. 

Point-solution data

Many employers already invest in mental health programs, musculoskeletal support, maternity care, or wellness counseling. Engagement and outcome data from these solutions can validate which programs are working and determine where more education is needed. 

Biometrics & screenings

Data from onsite or near-site clinics, wellness fairs, or health assessments can provide aggregate insights into blood pressure, cholesterol, or body mass index (BMI) trends across an organization.  

Taken together, these data sources offer a comprehensive view of employee health.  

Turning Data into Well-being Strategies

Access to data is only the first step. The real value comes from translating insights into action. Employers who create successful wellness programs follow three key practices: 

	Detect Risks Early Self-funding data can help employers identify health risks before they escalate into costly claims. For example: Pharmacy data might reveal that many employees are skipping diabetes medications, highlighting the need for support programs that help them stay on track with their treatment. Claims data could show rising ER visits for non-emergent issues, signaling a lack of education about the importance of primary care. Screening data may highlight elevated blood pressure trends across the workforce, suggesting an opportunity for heart health programs or challenges. By catching these red flags early, employers can educate employees about available resources and how to use them. Employers can also create wellness programs or health challenges that target prevalent health issues in the employee population.
	Design Tailored Programs Generic well-being initiatives often fail to engage employees because they don’t address real needs. With self-funding data, employers can design programs that are truly customized. For example: If musculoskeletal issues are a leading cost driver, employers can focus on ergonomics training, physical therapy partnerships, and incentivizing safe work practices. If maternity-related claims are increasing, employers can introduce maternal health support programs. If certain job types or locations show higher mental health needs, employers can provide targeted behavioral health resources and programs that support mental well-being at work and at home. When programs are guided by actual health data instead of generic models, employees engage more, and productivity improves.
	Align Incentives with Outcomes Self-funding data also enables employers to align incentives with measurable improvements. For example: Offering lower premiums or HSA contributions for completing preventive screenings. Rewarding medication adherence or participation in disease management programs. Tracking reductions in ER visits or hospital readmissions as program success metrics. By tying incentives to positive health outcomes, employers encourage employee engagement while also reinforcing a culture of well-being.

Measuring Impact: From Health to Productivity

The benefits of data-driven well-being initiatives go beyond reduced healthcare spend. A healthier workforce directly contributes to higher productivity, reduced absenteeism, and stronger retention.

Consider how different interventions can ripple through an organization: 

• Better chronic disease management reduces sick days and increases employee satisfaction.
• Improved mental health support lowers stress, enhances focus, and reduces turnover.
• Consistent preventive care keeps employees healthier longer, avoiding costly and disruptive treatments and hospitalizations.

How Employers Can Get Started

Here are four practical steps to start leveraging your data for employee well-being:

• Partner with a third-party administrator (TPA) or network partner who can help you interpret your claims data.
• Audit your current data sources: Take inventory of the information you already have, including medical and pharmacy claims, eligibility, demographics, wellness program engagement, biometrics, or point-solution data. You may be surprised at how much you’re already collecting.
• Set clear goals: Define what success looks like for your organization. Are you aiming to reduce avoidable ER visits, improve preventive screening rates, or boost participation in mental health programs?
• Measure and refine: Establish metrics, track progress, and adjust programs based on results. Measuring outcomes not only demonstrates ROI but also ensures programs remain relevant to evolving employee health trends.

Employers who use data to design and refine their wellness programs can track not only healthcare savings but also workplace performance indicators, including absenteeism rates, disability claims, and employee satisfaction. Over time, this creates a positive feedback loop where healthier employees drive stronger organizational outcomes. 

Want to uncover opportunities in your data? Contact The Alliance to unlock your Smarter Health^SM analysis, a customized data report that empowers you with healthcare analytics that provide data-driven insights.