What data are you currently receiving from your athletic insurance partner? If the answer is an annual report that summarizes your total paid claims over time, then your broker is missing the mark.
As our society is quickly learning, data is king. Large corporations and governments mine personal data on a daily basis. Everything from what you buy online to your travel habits is being accessed and analyzed. The more data that these companies have, the easier it is to predict what you might do (or buy) next. In the same way, the more data you receive from your secondary athletic insurance provider, the better you'll be able to make strategically-sound decisions regarding the effectiveness of your program.What types of reports should you be receiving?
At a bare minimum, you should be receiving monthly reports outlining the following: total billed charges resulting from specific injuries, the amount paid by the primary insurance company, the remaining balance owed prior to the application of secondary insurance, any discounts secured by your secondary insurance carrier, and finally, the actual amount paid by your secondary insurance company. This information can be used to evaluate the impact that uninsured athletes are having on your annual program costs.
Taking the data a step further, good Third-Party Administrators (TPAs) are able to sort your data by medical provider, by sport, by anatomy, by injury date, by athlete name, by paid total, etc. Any data that you are providing on the claim form should, theoretically, be reportable. Unfortunately, this is often not the case. Some athletic insurance brokers are purely reactionary and focus solely on the paid claims totals. You should expect (and demand) that detailed data be provided in a way that can be used to analyze and improve your athletic insurance program.
And possibly the most insightful, a report that provides the annual breakdown of total billed charges, the amount primary insurance paid, followed by amount that your TPA or claims administrator has saved through direct agreements or repricing networks and then your total paid dollar amount. Evaluating the percentage paid by primary insurance and then the total paid as a percentage of the billed charges will give you a great understanding of where your program excels and where it struggles.
What can be discerned from this data?
While it is true that data won't be able to prevent injuries from happening, it can be used to look for trends and help identify a game plan to lessen the severity or frequency of particular injuries. Armed with a report sorted by sport and further sorted by anatomy, we can see, for example, that an institution's women's soccer team has suffered an extraordinary amount of hamstring injuries over the past three (3) years. Communicating this information to the sports medicine staff and strength coach can help focus training regiments on the hamstrings and work to reduce the frequency/severity of this type of injury in the future.
On the business side of the program, if you can review a report that is sorted by medical provider, you can quickly gain important financial information about your local partners. For example, perhaps the data reveals an otherwise hidden trend that athletes needing MRIs are frequently sent to the hospital as opposed to a local imaging center that is eager to partner with your institution, through some type of in-kind contribution of services, as part of a sponsorship agreement. Having this data can make a substantial impact on your bottom line but it starts with selecting a partner that specializes in athletic insurance and is able to strategically guide you through the data.
What should you do if you are not receiving the level of data you need?
If your athletic insurance agency tends to go quiet for nine (9) months of the year and then resurfaces during insurance renewal time only to provide you with a summary of your claims totals and focus discussions on historical loss ratios, then you should consider making a change. The sports insurance industry is constantly changing as TPA's become more technologically advanced. You deserve to have fluid access to your data, so that you can make sound decisions. But what good is data without a partner that can serve as an extension of your athletic department and help clearly articulate the meaning behind the numbers? In short, data is knowledge that can be used to control costs and minimize injury, but only if you have a partner that can provide it and help you use it.