The Power of Data: Why Self-Funded Employers Need Access to and Understanding of Their Healthcare Data

Data is the key to unlocking better healthcare outcomes and financial sustainability for self-funded employers. With the right insights, businesses can design benefit strategies that drive value, reduce costs, and improve employee health. But having access to data is only the first step. Understanding and acting on that data is what makes the real difference.  

The Role of Data in Self-Funded Health Plans   

Cost Containment and Transparency

One of the biggest advantages of self-funding is cost transparency. Unlike a fully insured model, self-funded employers receive detailed claims data that highlights exactly where their healthcare dollars are going. This level of insight allows them to: 

Without access to claims data, employers have to make decisions based on assumptions rather than facts. This can lead to missed opportunities for cost savings and a higher risk of unexpected financial burdens. 

Customization and Strategic Planning

A one-size-fits-all approach to health benefits doesn’t work because every workforce has unique needs. Data analysis allows employers to customize their benefits strategy to their employee population. For example: 

With access to real-time data, self-funded employers can make proactive, rather than reactive, decisions that lead to long-term sustainability. 

Quality of Care and Employee Health

Beyond cost, self-funded employers also need to focus on the quality of care their employees receive. Poor healthcare outcomes not only impact employee well-being but can also result in higher long-term costs due to avoidable complications and hospital readmissions. Data-driven insights help employers: 

By leveraging data, employers can develop targeted interventions, such as employee wellness initiatives, disease management programs, or partnerships with high-value providers. 

The Alliance Empowers Employers with Smarter Health^SM Analysis

Understanding data isn’t always easy. Even with access to claims, employers often struggle to translate raw numbers into actionable strategies. That’s why The Alliance provides Smarter Health^SM analysis, a customized data analytics report designed to help employers make informed, data-driven decisions by providing insights, not just numbers. What is Smarter Health^SM Analysis? Smarter Health analysis is The Alliance’s proprietary data analytics tool that provides in-depth insights into an employer’s healthcare utilization, cost drivers, and provider performance. This customized report helps businesses: 

The analysis goes beyond simple reporting—it delivers clear, actionable recommendations tailored to the unique needs of each employer. 

How Smarter Health^SM Analysis Drives Better Decisions

The Alliance’s Smarter Health^SM analysis helps employers: 

1. Gain Clarity on Spending Patterns

By breaking down claims data into meaningful patterns, employers can see exactly where their healthcare dollars are being spent. Whether it’s hospitalizations, outpatient services, prescription drugs, or specialty care, the report identifies cost trends and areas for potential savings. 

2. Improve Provider Selection

The Alliance leverages data to assess provider performance, helping employers steer employees toward high-value care. By using objective cost data, businesses can ensure their employees receive good care at a fair price. One employer-member of The Alliance saved $94,000 while offering care at $0 out-of-pocket when employees used preferred-value providers. 

3. Optimize Benefit Design

Smarter Health^SM analysis allows employers to fine-tune their benefits structure based on actual utilization patterns. This could mean adjusting co-pays, adding incentives for preventative care, or expanding coverage for high-impact services like mental healthcare or chronic disease management. 

4. Reduce Waste and Unnecessary Costs

Employers can identify cost outliers and work to eliminate inefficiencies. The Alliance provides guidance on alternative solutions that can improve health outcomes while reducing expenses. One employer-member of The Alliance was able to keep their premiums and per-member per month costs stable year-over-year by guiding employees to high-value care. One school district saved $18 million by steering their employees to high-value care with The Alliance. 

5. Enhance Employee Engagement

When employees understand their benefits and how to navigate the healthcare system effectively, they make better choices. The Alliance helps employers develop communication strategies that encourage employees to utilize cost-effective, high-quality care options. If you’re an employer-member of The Alliance, reach out to your Account Executive for these educational resources.  

6. Real-World Impact

Employers who leverage The Alliance’s Smarter Health^SM analysis have seen significant improvements in both cost management and employee health outcomes. By applying data-driven insights, businesses have: 

These real-world successes showcase the power of data-driven decision-making in self-funded healthcare plans. 

The Future of Data-Driven Healthcare for Self-Funded Employers

With healthcare costs continuing to rise, self-funded employers cannot afford to operate without data. Access to – and understanding – healthcare data is crucial for making informed decisions that optimize costs, improve care quality, and enhance employee well-being. With the right data analytics and expert guidance, employers can create smarter health plans that drive better outcomes for both their bottom line and their employees. Reach out to The Alliance to learn how we can support your business and your employees.