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Beware of shiny new objects: In health care, good old-fashioned data may win the day

Is spending money to save money really the best option?

There is no doubt that technology is rapidly changing our world…not only in how we communicate, but in the way we do business. Consider the boom of companies like Amazon—the largest retailer in the world that owns no stores. Or Uber–a transportation company that owns no cars.

But can the same technological innovations be applied to healthcare? For example, can we ever take the physician out of the equation for anything beyond acute, routine care? My wife often uses an iPhone app to find an after-hours nurse to care for one of our children, but she still receives an in-home, face-to-face visit from a provider. The app is merely what connects her to that provider.

There are many other companies that are pouring tons of money into developing snazzy tools that promise to save employees (and by extension—employers) money on their healthcare spend. Wellness programs to make people healthier; cost and quality tools to help employees find the best deal and “shop” for providers. But the catch is that all these companies are competing for dollars from employers who are already fatigued by rising healthcare premiums. Is spending money to save money really the best option?

Ironically, what appears to be the best “new” thing is not a flashy web program or nifty app, but good old-fashioned data. It’s called Total Cost of Care (TCC), and it provides cold, hard numbers about healthcare costs in a given area, at a very granular level. TCC is the result of a decade’s work among health plan executives, actuaries, consultants and industry vets to consolidate data that will help employers shop for a health plan in extreme detail. It will show which network performs the best in their area for populations with similar risks and demographics as their own. Many employers would be surprised to know that the health plan/network offering the greatest discounts up front may not always be the best choice. How these plans perform long term, with a given population will tell you much more about the actual costs you can expect for your group.

If the concept takes off like I think it will, then employers will continue moving toward plans/networks that offer narrow, quality-driven and integrated coordination of care for their employees, and all the other shiny new apps and cost-cutting tools may not be necessary.

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