Encore! EP372: Step One for Employers and Unions—Get Your Data, With Cora Opsahl

For a full transcript of this episode, click here.

Why did I decide to encore this episode where Cora Opsahl from 32BJ spends 29 minutes talking about the importance of getting your data if you are an employer or a union health fund? Let me quote Jeff Hogan with some light edits here. Jeff wrote about the “outsized role” that employer data and intentional analytics can and will play. This is emerging and a must-have. The show with Andreas Mang (EP419) from three weeks ago, the show with Dan Mendelson (EP385), the one with Mark Cuban and Ferrin Williams (EP418) … everything that has been talked about in all of these shows and more is gonna be hard to do without having the data so you know what’s going on. But I will let Cora Opsahl explain far more succinctly than I can here.

One more note before we dive in here: After you listen to this show, you might want to go back and listen to episode 373 with Cora—and that one is entitled “How to Kick a Big Hospital Out of Your Network”—because this is one of the things that 32BJ did when it got its data. 32BJ realized that if it kicked out the really expensive hospital from their network, it would (and did!) save $35 million. Kicking this one hospital out of its network enabled the union to get its biggest wage hike in however many years, and also the employers employing union members got a premium holiday and did not have to pay into the health fund for a few months.

Imagine if they didn’t have this data and realized the millions and millions of dollars being siphoned out of the plan by this one hospital charging way too much. It’s just crazy how many employers or unions wind up becoming imprudent fiduciaries because they just don’t have the data to know better. But I’ll tell you who is realizing it: class action attorneys.

In this healthcare podcast, I am speaking with Cora Opsahl, who directs the 32BJ Health Fund.

Important to know about Cora’s background is this: In previous roles, she’s worked deep in the inner workings of the healthcare industry. So, she came to 32BJ armed with a BS meter that is finely tuned, which is, unfortunately, an essential skill for anyone trying to help the patients and members relying on them to successfully navigate the healthcare industry.

This conversation gets into everything that the 32BJ Health Fund does with their data. They have lots of data. They demand it. So, besides kicking out overly expensive health systems from their network, here’s other things that 32BJ is currently doing with their data and which other employers and unions may get a few ideas from. If you have the data, you (like 32BJ) can use it to:

• Make smart benefit decisions that are validated, not just guesses. Before you decide to do something (add a wellness program etc), be able to model it accurately for how much it will actually cost you—which, spoiler alert, is most of the time not what the vendor will estimate. You have way more data than the vendor does, so you can certainly use it to great effect in this way.
• Make sure that the right members are being communicated with so that benefit designs are successful. As Ashleigh Gunter said in episode 368, success when changing benefit designs has a lot more to do with communication than many realize.
• Create dashboards for leadership that may show trend lines, for example, which could be very helpful to ensure that the fund doesn’t run out of money etc … little things like that.
• Figure out how much the fund is spending on various procedures and where. There’s all this talk right now about the crazy variability of prices for the same exact service in the same local market. At one hospital, a colonoscopy could literall