This field guide is designed to equip employer-sponsored health plan organizations with the knowledge and practical tools needed to obtain, secure, and use health care data.
As a plan sponsor, you play a crucial role in managing health care benefits for your employees, and this guide will provide a roadmap for navigating the complexities of health care data access.
By understanding the legal landscape, data requests, and best practices for handling health care information, you can better fulfill your fiduciary responsibilities and make data-driven decisions that improve the cost-effectiveness, transparency, and quality of your health plan.
This guide is a practical resource to help employers:
- Navigate legal requirements to access essential data.
- Structure requests for comprehensive health care data from TPAs, PBMs, and other third parties.
- Handle health care data securely and in compliance with HIPAA and other regulations.
- Analyze and apply data insights to optimize plan design, manage costs, and uphold your fiduciary duties.