Health Plan Economics Newsletter : Issue 1

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Issue 1 : First Quarter 2009


	Three economy-driven reasons why self-insured health plans should brace for claim increases and fund reserves accordingly

	BenefitsWatch - A Client-Driven Solution

	HDM Launches a New Website

	Case Study of the Quarter

HDM released the following story to the business and general press this week. Every one we touch with Health Plan Economics should be aware of the economy-driven reasons why claim cost is rising, and why, with increased health plan expenses, there is a corresponding need to reconsider reserve funding.	This story was picked up by media nationwide.

Healthcare Data Management, Inc. (HDM), a leading, independent provider of health plan analytics for public corporations, Taft-Hartley plans and government agencies, sees storm clouds ahead for self-insured plans. “If CFOs are not taking today’s economy into account in anticipating medical expenses and reserves, employers...

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Contact Editor:
800.859.5119 x285 or send an email to
editor@hdminc.com

Next Issue:
Random Sample Versus Claim-by-Claim Audits

Since its founding in 1992, HDM has always been a client-driven company. In fact, when we became the first to model the ASO and SPD that was a direct response to our clients asking for a more complete way of monitoring administrator compliance with a retrospective audit.

In 2008, we again polled our clients for their thoughts on what was lacking in health plan auditing today. The response was resounding, and unanimous: plan sponsors, particularly CFO’s, want total control over their self-insured plans. They want the sea of data they receive from administrators and other sources to be analyzed and turned into actionable information...

	This case study, reprinted from the March 4 online edition of Employee Benefit Advisor, illustrates the need to monitor the performance of self-insured plans on an ongoing basis, to identify and correct minor issues before they become big, costly problems.

	State auditors say benefit managers cost the state about $11 million because they failed to take advantage of drug savings baked into their pharmacy benefit management contract...

	read more>

HDM has a new presence on the Internet...
a new Website launched days ago at www.hdminc.com. The Site contains in-depth information on HDM's three different types of services: BenefitsAudit, our retrospective compliance audit; BenefitsWatch, the first service of its type available for monitoring all three critical areas of plan performance – compliance, budget and cost and utilization – and specialized audits, particularly dependent eligibility audits.

There’s a helpful section on self-insuring that covers a range of related topics from Cost and Risks to Medical Loss Ratio and Sarbanes-Oxley compliance for sponsors of public corporation health plans...