Health Care Data Analytics

Optimize your plan design with Health Insights

Health Insights from Benefitfocus unlocks the power of your health care data to help your organization understand and control cost drivers and improve health outcomes.

Find out more

Animated man in front of large screen. Screen contains images of 2 pie charts and a bar chart.

The Challenge

Many organizations today are spending more on benefits but getting less in return.

of members drove 33.4% of total medical and pharmacy spend in 2025.¹

54%

of the total covered populationhas at least one chronic condition and treatment costs continue to rise.¹

29.5%

of total 2025 benefits spending was attributed to pharmacy costs, up from 2.3% in 2024.¹

How Our Solution Is Different

Health Insights offers a thoughtful combination of health care data analytics, machine learning and experienced analysts that help you and your advisors find ways to optimize the impact and ROI of your benefit strategy.

Find out more

Answers for everyone Whether you’re looking for a quick snapshot to provide an executive update or an in-depth analysis to share with your benefits advisor, our simple user experience and extensive customization options help you find the answers you need.
Actionable insights Through data visualization, Health Insights makes it easier to understand the metrics that matter, evaluate performance and identify areas in your benefit strategy where you may want to take action.
Data flexibility We’ve spent over two decades successfully aggregating disparate data and making it useful to our clients. Whatever data you want to bring in – from dental and vision claims to member biometrics – we’ve got you covered with high levels of data integrity.
Experienced support With an average of 13+ years’ experience working with health care data, our dedicated client success team members work as consultative partners to help you maximize the value of Health Insights and achieve your goals.
Valuable benchmarks Enriched data sources and strategic integration of machine-readable files are available to help you compare your data to industry benchmarks.
Analytics & engagement When combined with Benefitfocus’ enrollment and communication tools, Health Insights offers a powerful way for you to personalize the benefits experience for employees and help guide them to smarter, more impactful plan selection and utilization decisions.

Health Care Data Analytics Brochure

Learn more

Use Cases

Customers use Health Insights to:

Identify and manage cost drivers
E.g., Emergency Room use for non-urgent care
Reduce wasteful spending
E.g., Claim errors that lead to overpayments
Evaluate vendor impact
E.g., Disease management program effectiveness

Key Capabilities

Standard dashboard: Access out-of-the-box reports to get quick answers to the most common questions.
Custom reporting: Slice and dice your data for custom, in-depth analysis to support specific initiatives.
Benchmarking: Evaluate how your plans and programs are performing against key national indexes and market rates.

Care management: Understand gaps in care to help improve preventive health utilization and chronic condition management.
Member populations: Segment and track specific populations to measure outcomes over time.
Benefits Decision Support: Give employees access to tools that help them understand their utilization and coverage needs. Learn more

Frequently Asked Questions: Health Care Data Analytics

Health care data analytics is the practice of integrating and analyzing medical, pharmacy and benefits data to uncover trends that impact cost, quality and outcomes. For employers, it creates visibility into the true drivers of health care spend, helping you identify opportunities to improve plan performance. With clearer insights, organizations can make proactive decisions that can help save costs, strengthen their overall benefits strategy and support employees’ well-being.

Without integrated data, it’s difficult to see patterns in employee health care data. Health care data analytics helps organizations reveal those patterns to help tackle rising costs, inefficient plan designs and poor benefits utilization. By gaining clarity through a health care data analytics solution, employers can identify high-cost claimants, compare plan performance, monitor preventive care gaps and evaluate the impact of programs over time. These insights support more informed decision-making, better vendor oversight and a more effective, sustainable benefits strategy.

A health care data analytics solution brings together data from multiple sources—such as medical claims, pharmacy data, biometrics, and eligibility files—and normalizes it into a single, view. Dashboards, reporting, benchmarking tools, and predictive modeling enable employers and their providers to evaluate trends, uncover cost drivers and identify gaps in care—all within an experience that is designed to be intuitive and customizable to an organization’s specific needs.

Health Insights simplifies complex health claims and benefits data through a combination of deep data integration and an experienced team of health care data analytics professionals. The platform offers intuitive dashboards, extensive customizable reporting and predictive modeling. Its ability to integrate hundreds of data sources and apply clinical models, like the Johns Hopkins ACG® system*, sets it apart from traditional reporting tools.

For self-funded employers, independent health care data analytics is essential for fulfilling the Employee Retirement Income Security Act (ERISA) fiduciary responsibility. Your organization, not your broker or claims administrator, is responsible for ensuring that plan assets are used prudently. In today's litigious environment, relying solely on third-party reports may be insufficient; you can benefit from objective documentation showing independent review of costs, vendors and performance. Also, traditional retrospective reporting can't support real-time plan management. Independent analytics doesn't replace other partners—it can help strengthen relationships and enable strategic collaboration. Most critically, you need a unified view of interconnected medical and pharmacy costs to manage what is likely one of your largest financial risks effectively.

The optimal provider offers reliable data integration, strong security, clear visualizations and the flexibility to support a multitude of reporting needs. Look for a provider that combines technology with consultative guidance and provides insights your team can act on right away. A strong health care data analytics provider should help you control costs, evaluate plan performance, and improve employee health outcomes.

Featured Content

The Truth About Why Your Employees Need Better Benefits Decision Support

Examine why a benefits decision support solution is so important to helping employees to make informed and personalized benefits choices.

Learn more

The Top 5 Signs Your Employees Are Struggling to Understand, Choose and Use Their Benefits

Most HR professionals would agree that despite your best efforts, most employees still struggle to understand, choose and use their benefits, resulting in low engagement and sub-optimal outcomes. Here are some telltale signs that your employees aren't fully realizing the value of their benefits!

Learn more

How to Shift to a More Effective Benefits Administration Strategy

This eBook helps employers explore a smarter way to get workplace benefits and savings and sync while making the process easier for HR teams.

Learn more

Take a test drive

Schedule a consultation with a member of our team and see our health care data analytics solution in action!

Find out more

¹The State of Employee Benefits 2026 was compiled from enrollment transactions aggregated across 316 large employers (1,000+ full time employees) within the Benefitfocus customer base, representing more than 1.8 million employees in total. The data was evaluated on an anonymous basis. Enrollment records include both active and passive enrollments made by a variety of industry roles (employee, carrier representative, broker, benefits administrator, etc) from the fall of 2023 through fall of 2025 for plan year effective dates of January 1. These measurements are not meant to be a nationally representative sample, but to represent the aggregate activity for large employers on the Benefitfocus platform.

For data related to medical and prescription drug claims, Benefitfocus drew from 68 employers in our Health Insights Platform with a total population of approximately 600,000 employees and their dependents. Claims were assessed based on claim service dates from 1/1/24 through 12/31/2025, for year over year comparison periods. Population Health data was compiled using Johns Hopkins ACG® System (version 14.0.1). The underlying claims demographics and claims were sanitized per HIPAA Safe Harbor guidelines and were filtered to exclude generations older than Baby Boomers to comply with the age 90 cutoff mentioned in section (3) of “Guidance on De-identification of Protected Information. November 26, 2012” which cites the Code of Federal Regulations Title 45 §164.514(b)(2)(i)(C).” The information provided does not, and is not intended to, constitute legal advice; instead, all information and content herein is provided for general informational purposes only and may not constitute the most up-to-date legal or other information. Benefitfocus does not act in a fiduciary capacity in providing products or services; any such fiduciary capacity is explicitly disclaimed.

CN5163943_0128