Andy NearyI help insurance professionals turn brand awareness into business growth.

SOTSQ Episode 6 - It's all about the SIZE and FREQUENCY!

28 Jun 2018 · 1 min

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0:47

Short advisory video by Andy Neary arguing that healthcare budget predictability comes from focusing on the "size" and "frequency" of medical and pharmacy claims. He cites a 20%/80% distribution (20% of members accounting for ~80% of claims), argues wellness programs fail because high-cost members ("super utilizers") don't participate, and recommends targeting those members with cost-containment strategies to reduce budgetary impact. Ends with a brief invitation for feedback.

Chapters

You interested in bringing some certainty and predictability to your health care budget? If so, these are the two most important words you must remember folks. It's all about the size and the frequency. Think about this, if 20% of your members are driving 80% of your claims costs where should you focus? You need to focus on the size and the frequency of the medical and pharmacy claims coming from those 20% the super utilizers. This is why your wellness program isn't bringing any return on investment. The people who need the most help aren't participating. But when you focus on the size and the frequency of those medical and pharmacy claims from the super utilizers with strategies and cost containment solutions, I promise you you will take a chunk out of your health care budget. Alright that's it for now. If you like these messages and you're finding them valuable, just shoot me a note and let me know what you think and we'll catch you soon.