Measuring our success…

PlanCompass report highlights

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

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

Here are some highlights of the 2015 PlanCompass report for BHCG employers in aggregate, comparing 2013 data to 2014 data:

  • The percentage of large claimant (members having more than $50,000 in medical and pharmacy claims paid during the reporting period) spend increased to 42 percent of total spend in 2014 compared to 39 percent in 2013. 
  • The generic dispensing rate improved approximately two percentage points from 2013 to 2014. Compared to 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 31.5 percent in 2013 to 37.6 percent in 2014.
  • Inpatient days per 1,000 enrollees dropped from 189 per 1,000 in 2013 to 184 per 1,000 in 2014, while outpatient procedures per 1,000 enrollees increased from 1,158 per 1,000 in 2013 to 1,169 per 1,000 in 2014.
  • The top three major clinical condition areas of health care spend in 2014 were musculoskeletal, oncology and digestive 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), 95 percent were actually participating in one in 2014, up from 91 percent in 2013.

 




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