New Blue Cross & Blue Shield of Rhode Island analytics tool helps employers design data-driven plans


PROVIDENCE, RI – Blue Cross & Blue Shield of Rhode Island (BCBSRI) has launched an analytics tool aimed at supporting employers in creating effective health plan designs to integrate workforce wellness and ultimately lower healthcare costs. Part of BCBSRI’s Blue Insights health data platform, the tool provides employers with customized reports on utilization and healthcare needs, helping them make more informed plan decisions for their worksites.

With both Rhode Island’s median age and utilization of key healthcare services higher than the national average, honing in on employee needs and utilization patterns can be important in driving members to high quality, affordable choices. An example of a trend influencing plan design might be a report showing high emergency room usage among employees due to unmanaged chronic conditions. In that case, the employer may decide to work with their broker and BCBSRI client management team to integrate a coordinated care plan that features a dedicated primary care provider for each member and primary care access on nights and weekends.

“This innovative resource furthers our goal of addressing healthcare affordability by offering employers a tool to better respond to their employees’ health and wellness needs,” said Kim Keck, president and CEO of BCBSRI. “With information at their fingertips that can support important decisions on healthcare benefits, employers can feel more confident about structuring a health plan that offers choices and the opportunity for employees to become more engaged in planning their care.”

Developed with MedeAnalytics, the employer reporting tool is a Web-based application that measures and visualizes enrollment, utilization, financial and plan performance to create plan designs. Highly customizable, the tool offers automated reports that can be used to track medical, dental, pharmacy and vision data including:
• network performance,
• inpatient and outpatient analysis, and
• total cost of care

Blue Insights gives providers, employers, brokers and health plans the same data so that everyone on the team is connected for better health. Based on the information available, employers may choose to update their plan design at renewal to include lower cost network products, consumer directed plans or increased incentives for wellness. This also allows employees to be more engaged in healthcare decision making.

"The analytical capabilities we are deploying to our larger clients are completely changing the way we can support employers in meeting healthcare needs at a more affordable cost,” said Sam Slade, vice president of the employer segment at BCBSRI. “Our team of clinicians, underwriters, analysts and wellness experts are leading the local market in directly assisting our employer clients and their consultants in a collaborative process of examining the data and modeling solutions."

Group customers with more than 100 covered employees and their brokers or consultants will have access to the data at no additional cost.

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