A company's prescription drug claims data are most important to helping executives trim the cost of their health benefits and improve employee health outcomes, according to a new study from the Healthcare Performance Management (HPM) Institute, a Maryland-based research and education organization. This contradicts the findings of a recent insurance industry study.
"Some insurers claim that employers can save money on their workers' health insurance by bundling their medical and prescription drug benefits together. That's not surprising--bundled products are what the industry sells," said George Pantos, executive director of the HPM Institute. "Our research finds that unbundled prescription claims information offers more to company leaders by granting them a real-time view of how their employees are using their health plans. Armed with such data, executives can take action to mitigate costly health risks."
According to the HPM Institute report, medical claims data are less useful to benefits administrators because of the significant amount of time it takes doctors, hospitals, and insurers to process paperwork and approve claims. By contrast, prescription data is available almost instantaneously--as soon as the pharmacist fills the prescription.
"Prescription data offer executives crucial insights that they can use to construct supplemental health-enhancing offerings like medical interventions, disease management, and wellness programs," said Pantos. "Initiatives like these can help employers take control of potential employee health problems before they become costly."
A 2005 report from Mercer Consulting found that self-insured employers can lower their prescription drug costs by as much as 20% by purchasing a stand-alone self-insured pharmacy benefit as opposed to the bundled plan favored by insurers. Many executives have taken note- almost half of all companies carve out their prescription drug benefit to an outside manager.
To download a copy of the HPM Institute study, visit http://www.hpminstitute.org/node/115.