Measuring our success…

PlanCompass report highlights

PlanCompass reports are prepared annually by Humana for individual self-funded employers and for the BHCG, including aggregate information for both fully insured and self-funded employers. PlanCompass reports include comparative analyses against market and prior-year data to give individual employers and the BHCG personalized observations and recommendations. The goal of the PlanCompass reports is to help employers and BHCG:

  • Identify areas of concern
  • Understand the level of consumer engagement
  • Develop strategies to control spend

Some highlights of the 2014 PlanCompass report – for BHCG employers in aggregate – comparing data from 2012 with 2013 data include:

  • The percentage of large claimant (> $75,000) spend increased to 32 percent of total spend in 2013 compared with 30 percent in 2012. 
  • The generic dispensing rate improved approximately two percentage points from 2012 to 2013. Compared with Humana’s national book of business, BHCG’s generic dispensing rate was also two percentage points higher.
  • Specialty pharmacy as a percentage of total pharmacy net paid increased from 27.4 percent in 2012 to 30.2 percent in 2013.
  • Inpatient days per 1,000 enrollees dropped from 186 per 1,000 in 2012 to 184 per 1,000 in 2013, while outpatient procedures per 1,000 enrollees increased from 1,168 per 1000 in 2012 to 1,212 per 1000 in 2013.
  • The top three Major Clinical Condition (MCC) areas of health care spend in 2013 were musculoskeletal, oncology and exams and preventive services.
  • Of enrollees identified as those who would benefit from participation in a clinical management program (e.g. case management, personal heath coach, personal nurse), 91 percent were actually participating in one.

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