A Great-West news release said the reports also allow employers to spot ways to control costs and improve worker health and productivity. Great-West said the reports go to employers and insurance brokers via a new Web-based portal.
According to the news release, the enhanced reports include:
- an executive summary – a two-page report that includes high-level reporting elements
- medical performance reports including information on membership, demographics, costs/per member per month (PMPM) by provider type and service, total PMPM by major diagnostic category, diagnostic categories, cost-sharing summary, in-/out-patient physicians and facilities and providers, other providers, use of hospitals and facilities, paid claims by payment category, claims exceeding a financial threshold, costs by physician/provider type, total savings by provider and savings type, and network discount savings
- pharmacy performance reports including information on drug cost-sharing and drug costs by source, by amount paid, by use and by therapeutic class
- dental performance reports including information on membership, demographics, costs/PMPM by treatment category, cost-sharing summary and applicable network discount savings.
- vision performance reports including information on membership, demographics and costs by service type.
Additional reports include:
- disease management outcomes report that documents member enrollment and participation in programs for chronic conditions that account for significant claims costs, clinical measurements associated with these conditions such as hospital utilization and diagnosis, and use of prescription medication.
- neonatal and oncology program reports
- medical outreach activity report provides information on members’ use of Great-West Healthcare’s medical management program.
- total cost management summary quantifies all savings-to-date associated with the health plan, including network discounts, medical management, and disease management.
- group health risk assessment summary with company-specific health risks, showing where member education could be most beneficial.
More information is at www.greatwesthealthcare.com .
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