4.4 Benefit Analysis
The Benefit Cost Analysis report charts the break down of charges, expense, and usage across each benefit category. Benefit categories represent the coverage areas of the plan and are the building blocks of plan design. Understanding how the covered population is using various types of benefits can help determine the impact of modifying coverage.
Each category may include multiple "charge types" (sometimes refered to as
"benefit codes"). The individual charge types may be viewed by
drilling down into a specific category
and selecting Charge Type from the view options.
The graph displays how much the plan sponsor (green) and member (red) paid as well as the amount of savings obtained through network discounts (blue); the top of each bar represents the total original charge billed by providers. The numbers along the bottom of the graph can be matched back to the number (#) column in the table.
Other fields displayed in the table are as follows:
Total Charge: Original total amount billed by provider before network discount or other types of savings are applied. More.
Plan Paid: Total amount paid by plan sponsor.
% Paid ( Plan Paid Percentage ): The percentage of original billed charges paid by the plan sponsor. More.
% Usage ( Percentage of Usage ): The percentage of total dollars paid by the plan sponsor. More.
Benefit / Network Analysis
The Benefit / Network Utilization report shows network utilization and discount performance on a per benefit category basis. This is useful in determining coverage areas that could benefit from steerage or contract renegotiation.
