The prevalence and magnitude of large claims is growing at an alarming rate. Between 2013 and 2016, individuals with annual claims above $1 million increased 68% according to a recent report from Sun Life Financial. The report includes a list of the top 10 treatments producing high claims, which include a number of cancer treatments, as well as transplants and neonatal care.
Although high cost claims are unavoidable, you don’t have to be unprepared. Review your claims data and see which conditions are costing you the most. Armed with this knowledge you can implement programs to help prevent or reduce the severity of serious health issues; for example, with a program that identifies and helps women with high-risk pregnancies. Make sure high-cost claims get assigned to your plan’s care management program. Clinical oversight can help with the reduction of wasteful spending and ensure your member is receiving the right care, at the right place, at the right time. Appropriate oversight is a valuable investment that can produce measurable results.