As the old saying goes, “You can’t improve what you don’t measure.” Imagine you are a student taking a test and never knowing your grade. It’s nearly impossible to strategize a plan for improvement if you are unaware of your current performance.
This same principle applies to subrogation cases. Analytics are essential to evaluating the performance and effectiveness of any subrogation program. Armed with meaningful data and metrics, organizations can better analyze performance and make future strategic decisions.
Transparency and benchmarking
To make the necessary improvements, you need to know how your subrogation program stacks up against others. How do you know if your program is performing above average, in the middle, or just plain poorly? Transparency in data, both internally and from vendors, will reveal insights about your subrogation performance within the industry as a whole.
Benchmarking also gives subrogation professionals some guideposts on where their programmatic weaknesses and strengths may lie. What is needed now is a cultural shift by vendors and health plans to increase operational transparency and provide real benchmarking. Health plans should have full access on a 24/7 basis to all case details housed in their vendors’ case management applications, including incoming and outgoing correspondence, telephone calls, activities and diaries of activity.
Real-time dashboards, such as the one offered by Discovery Health Partners, provide on-demand information and metrics that illustrate the current status of your subrogation inventory. Dashboards are able to integrate information from multiple vendors as well as hybrid models, providing the user with the fullest and most accurate picture.
Examples of data that should always be available to the health plan include information on daily, monthly, and annual recoveries; case inventory data; and vendor performance metrics. This data should be sortable by client, funding source, accident type, and specific date range. Reports should be easy to run and offered in a user-friendly format that will help business users understand subrogation performance.
Closed case data can be particularly instrumental in demonstrating why you are recovering on some cases, and not recovering on others. Again, a dashboard system allows the user to sort by cases that have been and have not been recovered and the reasons why the plan is and is not recovering. Next, that data must be able to be filtered by claim type, plan type and other relevant recovery factors. The ability to analyze your data will allow you to evaluate subrogation program performance and then make strategic decisions regarding future program improvements.
Discovery Health Partners has seen dramatic results using the next-generation subrogation solutions outlined in our series. Discovery Health Partners’ subrogation solutions have helped health plans across the country increase recoveries by millions of dollars within a year of implementation. With these best practices, Discovery Health Partners leads the path forward for health plans to improve subrogation recovery rates and ultimately contain costs.