Business of Well-being

How to Steer Your Plan Design: Leveraging Your Data with Abett


A silver lining of the coronavirus pandemic has been how it disrupted healthcare systems, driving solutions to tackle disease and improve health outcomes. With the rapid adoption of digital tools during the pandemic, healthcare saw a notable merger with tech that delivered outstanding results that will revolutionize the future of workplace health and benefits for years to come.

One of the challenges employers faced in the pre-pandemic era was accessing and using data to improve healthcare decisions. However, the last few years have birthed an innovative tool for employers, a 'lockbox' that addresses many issues around data, providing employers with a plug-and-play network of resources to make better healthcare decisions for their population.

At this year's Healthcare Revolution conference, which was on April 26-28, Jonathan Edelheit, Chairman and Co-Founder of Global Healthcare Resources, spoke with Diana Dimon, former Senior Manager of Benefits at Linde, about the potential impact of Abett's data 'lockbox' on employee healthcare and benefits.

Tell us a bit about yourself

My name is Diana Dimon, and I am the Senior Manager of Benefits at Linde. I currently oversee all of our US health and welfare plans, and that includes everything from medical, dental, vision, and disability plans.

What do you love about your job?

I love that what I do daily inherently helps people, whether it's a simple phone call to an employer helping them understand what they could do differently in the healthcare system or helping them get prescription drugs at a lower cost. Basically, I enjoy that I am helping people in areas of employee healthcare and benefits that they have no expertise in.

However, like everyone else, my job comes with some challenges. What makes this job hard is that people don't understand benefits and the healthcare system. People usually make decisions about their health from an emotional standpoint. So you can have the best solutions and plan design for your employees, but all of that can be thwarted by a person's emotional state at that point in time when they have to make a decision to use those benefits.

How would you define the good and bad actors in the industry? 

The good actors are the ones that are driven by achieving a good health outcome for the person they are caring for, while the bad actors are the ones making money off of the people being sick. The idea that someone exploits employers or health payers for someone elses' illness makes them the bad actors in the healthcare industry.

Data hoarding is one of the challenges in the industry. What has been your experience with this?

I have had many challenges getting the right data from various vendors in my career. In one instance, I spent more than 18 months trying to get data from one vendor, and then after finally agreeing to share them with my team, I ended up waiting for another two months. So vendors come up with many excuses and put up many barriers that make it challenging to access data.

You have overcome this challenge by implementing a lockbox; how much has that helped? 

It's been a major game-changer in helping employers make better decisions for their workers' health. About two years ago, when we launched Abett, it helped us house all of our data in one place and also helped us get the right data points back out to our point solutions, which really helped our employees. Abett helps us focus on the right population; for instance, not wasting time seeking second opinions for healthy people but people who really need a second opinion - those with a diagnosis.

How were you able to do this before Abett?

It was nearly impossible before Abett. What we experienced before then was that we were finding out about things after we had paid claims for them — for example, paying claims for chemotherapy. This was already too late for someone who had a cancer diagnosis; there was really no way we could help or change the course of treatment for such individuals.

With Abett, we have access to timely data, and we have individuals who can manage these data to provide early intervention for employees with some health concerns. However, we are closer to gaining full control of the narrative; there are still times when we struggle to get data. To a large extent, we still depend on our carriers to move with our plans as they control much of the narrative. But where we have a lot of control is our access to relevant data; we can easily tell carriers what their competitors know and have and what they don't. This is the biggest game-changer in influencing their decisions in the direction of data.

So this changes the conversation and how we speak to the vendors; since we have access to data, we can negotiate with vendors and other industry key players to make better healthcare decisions for employees. Admittedly, Abett has also helped us to get rid of vendors that aren't moving fast enough for the good of health buyers. Before now, we could get stuck with an ineffective vendor for five or six years because we needed them. Now, with the ease of getting data feeds, we control our data, and we control the pace.

What would you advise employers listening regarding planning data with Abett?

I'd say employers need first to understand why they have benefits in place. Is it just to offer benefits or to retain talent based on it? And then, how are you steering your plan design? If an effective data design helps you make better decisions about benefits, then employers should know that they will not get such data easily from vendors, as I have alluded to earlier. Abett helps employers access a warehouse of data with minimal effort in the background and, more importantly, bypassing the barriers to data access.

For us, when we started, it was about having control over our data. If you need to move quickly on an issue, Abett gives you that flexibility. For instance, leveraging Abett helps us bypass the over six to eight-month leave time in cancer intervention using HRIS systems; hence, we can act fast and early. Ultimately, this leads to immense cost savings for employers with timely healthcare decisions and interventions.

Outside of Abett, what other innovative ideas are you excited about?  

There are a few of them, like identifying fraud, waste, and abuse in the industry. For instance, if you have wrongfully made a claim or a provider has been billing incorrectly, someone is out there that can help you get that money back. We have been able to achieve this by leveraging Abett's efficient data system. We are also looking forward to pointed solutions such as in the cancer space, for instance, solutions to diagnose cancer earlier and provide timely intervention. Now that we've gone past getting data, we now have to find solutions that use these data to make better and smarter decisions.

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