Management Consulting
Aon
Full Credential Description
In a recent discussion on the Aon Podcast, experts highlighted the growing challenge of high-cost claimants in healthcare, which are significantly impacting employers' medical expenses. High-cost claimants, defined as the top 5% of claimants driving approximately 60% of health plan spending, are increasingly associated with complex and chronic conditions. These conditions, such as cancer and cardiovascular diseases, are becoming more predictable and frequent, leading to a projected increase in U.S. medical costs by 9-10% in 2025, translating to about $16,000 per employee. To address these challenges, Aon developed a tailored solution utilizing predictive modeling through their Health Risk Analyzer. This tool helps employers understand their future risk rather than relying solely on historical data. By identifying high-risk individuals within their health plans, employers can implement targeted care management programs aimed at prevention and mitigation. For instance, Aon worked with a large tech company to analyze high-cost claims, allowing clinicians to engage with at-risk individuals proactively, thereby improving care management. One notable success story involved a large transportation company that was investing heavily in a care management program but was unsure of its effectiveness. Aon's analysis revealed that half of the identified high-risk individuals were not being engaged by the existing program. By collaborating with the navigation vendor, Aon helped increase engagement from 5% to 20%. This increase in engagement is significant, as it is estimated that each engaged individual can lead to approximately $1,000 in savings. Overall, the combination of predictive analytics and clinical consulting not only aids in managing healthcare costs but also enhances health outcomes for employees, demonstrating a proactive approach to mitigating the risks associated with high-cost claimants.