Apples to apples health plan comparisons may finally be possible with Total Cost of Care

Networks/carriers use of cost and quality control tools such as utilization management, physician referral patterns and disease management are significant and could have a consequential impact on the actual costs of the network. Luckily a forward-thinking group of industry professionals determined that employers needed access to all claims and cost data in very specific geographic locations, so a deeper and much more meaningful financial analysis could be presented. These professionals represent consultants, carriers and others with skin in the healthcare game. They created the Uniform Data Specifications (UDS) group to try to standardize how data is presented so all employers can benefit. They’ve been quietly working behind the scenes for several years, and the fruits of their labor can now be seen. I’ve outlined the concept in greater detail for the current issue of Building Profits magazine. Read it here.