Lehigh Valley Business Coalition on Healthcare Q2 2024 Employer Meeting

Thank you to those who were able to attend the Coalition’s Employer Group meeting on June 11th. For those who could not attend or would benefit from a recap, here are some important takeaways from the meeting.

Annual Claims Review

Dr. Robert Muscalus, Capital’s Senior Medical Director for Client Analytics, provided more than two years’ worth of Coalition member claims utilization. Generally, his findings and analysis included the following points:

  • Many key performance indicators, including total medical paid figures, indicated a utilization increase in outpatient and professional care, but a decrease in inpatient care, from 2022 to 2023.
  • Overall total spend, along with average PMPM spending, increased over the time period by 4.2% and 2.4%, respectively.
  • In looking at 2022-2023, inpatient admissions did decrease and the average length of stay for those who did receive inpatient care remained consistent.
  • In-network utilization was near 99%, with more than $1.5B in Blue contractual savings.
  • Nearly 60% of the membership is attributed to a provider in a value-based care arrangement.
  • Provider distribution (i.e., top utilized providers) has continued to remain steady with the top 3 being LVHN, St. Luke’s and Reading Hospital.
  • Other key areas of focus included mental health and wellness, as well as preventive services and quality metrics.
  • Lastly, Dr. Muscalus offered some insight and discussion on emerging trends in weight loss medications across the industry and within the LVBCH employer group.

Save the Date!

The next Capital/Coalition quarterly employer meeting will be on Tuesday, September 10th at 9am. More details in an invitation to follow, later this summer.

For more information on Capital Blue Cross programs and services, please contact your Capital Blue Cross account executive.