Smarter HealthSM Analysis
We empower employers with healthcare analytics that provide data-driven insights. Those insights drive serious savings because they offer employers guidance on steerage and incentive programs.
Deep-Level Healthcare Analytics
Unique to each employer, Smarter HealthSM is a healthcare analytics report that provides the foundation for a successful employee steering program.
Using these healthcare analytics, employers gain transparent access to their healthcare claims data, providing deep visibility into where their healthcare dollars are being spent — and where they can save — without compromising the quality of care.
Smart HealthSM analysis is only available to employer-members of The Alliance. The analysis also requires two years of data for pinpoint accuracy.
Here’s what you can expect from your personalized healthcare analytics report:
- Your employee population’s ER, urgent care, and primary care utilization
- Steerage recommendations sorted by procedure/service and location using a 100-mile radius
- Your employee population’s out-of-network charges and their average cost vs their in-network utilization
- Total savings estimate for changing providers sorted by procedure/service
- And more!
Provider Network Design
Our Provider Networks are Smarter NetworksSM – designed to help employers save money and drive new Benefit Plan Design innovations. By contracting directly with providers on behalf of employers, The Alliance ensures high-quality, convenient, and cost-effective access to care for employees and their families.
The Alliance Provider Networks have continuously evolved over the past 30 years to serve the needs of more than 425 employers throughout the Midwest – each with their own unique goals and challenges. As a not-for-profit coalition of self-funded employers, The Alliance places an emphasis on cost and quality measurement when adding providers to our network. Our networks continue to evolve to meet the needs of our employer-members.
Benefit Plan Design
We are your advocate for Benefit Plan Design.
- Ever-expanding options
- Comprehensive care everywhere
- Tiered benefit plans
Our solutions allow employers to drive down the total cost of care by aligning incentives and customizing networks regionally to maximize employers’ investments in their health benefits.
Steering Employees with Data
Our proprietary Smarter HealthSM analysis offers deep insights into where your employees are seeking high-cost care — and where you can save — without compromising healthcare quality.
The first step in steering employees to high-value healthcare is to identify high-dollar claims based on your health plan costs. Then, examine which claims you spend on most frequently and where you spend it. This is a foundational piece in creating a successful employee steering program.
Cost Saving Opportunities
The Alliance negotiates lower costs based on percentages of Medicare prices, but costs for a specific procedure can still vary greatly between providers.
For example, the cost of surgery to place ear tubes in young children (myringotomy) is just one procedure that greatly varies in cost depending on where treatment occurs. Fortunately, some providers do a high volume of these surgeries – an indicator of quality care – and those providers are also likely to have better contracted rates because of it.
Incentives are a Win-Win
Once you identify where you can achieve significant savings, the next step is getting employee “buy-in.” Financial incentives that reward employees for choosing high-value care are crucial. To put it simply, you must share the savings with employees so you both reap the benefits of choosing a preferred-value provider – a well-designed incentive means everyone saves.
Communication is Key
If employees don’t know about your new incentives, they won’t use them, so communicating incentives is a crucial component of steering. Employers need to share information with employees in many forms and on a consistent basis so employees remember the incentives when making healthcare decisions.
Steering Works for Employers of All Sizes
Steerage programs aren’t just for small-to-midsize businesses. Companies like Wal-Mart, Lowe’s, The Boeing Company, Pepsi, and Safeway have all implemented changes that steered employees to higher-value care that saved both their businesses and employees money.
- Wisconsin alone could save $394 million per year if employers steered their patients to lower-cost providers. Contact the Account Management team to find out how much you could save.
- Creating benefit designs that explicitly encourage consumers to act on price and quality information, including reference pricing, tiered networks, centers of excellence contracting, and value-based insurance design (V-BID), is a step toward a system that provides and rewards high-value care, while simultaneously driving waste from the healthcare system.
Our patient tool, Smarter Care AdvisorSM, helps employees understand where to find a procedure and how much it might cost. They can search for services within a 100-mile range of their location and get contact information for a provider along with a cost estimate! Smarter Care AdvisorSM helps educate and empower employees to make better healthcare decisions, which is a powerful part of a successful steering program!