Your Claims Data is the Key to Stabilizing Your Health Plan Costs

If you're an employer in the Dallas-Fort Worth area offering health plan benefits, you're all too familiar with the seemingly never-ending increases in your annual premiums. Staring down a 10% or higher hike in your 2025 costs can feel incredibly frustrating, especially when you're committed to providing quality, affordable coverage for your employees.

The good news is, there is something you can do about it - get access to your claims data and use the insights to start taking back control.

You Have a Right to See Your Claims Data

One of the most powerful tools at your disposal as an employer-sponsored health plan sponsor is the ability to access detailed claims information. This data provides a window into how your plan is being utilized, what your employees are spending on healthcare, and where there may be opportunities to reduce costs.

However, many employers don't realize they have a right to this information or simply don't know how to obtain it. If your insurance carrier isn't forthcoming with claims data, work with your broker to request the details you need. At minimum, you should be able to get high-level reporting on total claims, top diagnosis codes, and utilization trends.

Use Claims Data to Identify Cost Drivers

Once you have your hands on the claims data, it's time to put it to work. Look for patterns and areas of high spending that could be driving your premium increases. Are there certain conditions or procedures that account for a disproportionate share of your total claims? Are there opportunities to encourage employees to seek care in more cost-effective settings?

The insights you glean from your claims data can inform strategic decisions around plan design, wellness initiatives, and vendor partnerships. You may even uncover opportunities to implement targeted interventions that address your specific population's healthcare needs and spending habits.

Partner with Experts Who Can Help

If examining claims data and translating the information into actionable steps feels overwhelming, don't worry. A knowledgeable broker or consultant can not only obtain the detailed claims data you need, but also provide guidance on interpreting the findings and developing a customized strategy to bend the cost curve. Their expertise can be invaluable in a healthcare landscape that seems to get more complex by the day.

If you need help, we specialize in helping employers just like you take control of their healthcare spend. Don't resign yourself to perpetual double-digit premium hikes. Take the first step by demanding access to your claims data - it could be the key to slowing the rise in your health plan costs.