Scoping Review of Employer-Led Research Using Employee Health Claims Data.

Area of Science:

• Occupational Health
• Health Services Research
• Data Analytics in Healthcare

Background:

• Employers use employee health claims data for various purposes, including evaluating insurance and wellness plan effectiveness.
• Monitoring employee health trends and identifying areas for wellness interventions are key drivers for data evaluation.

Purpose of the Study:

• To describe the literature on the use, applications, and outcomes of employee health claims data by self-insured employers.
• To synthesize findings from a scoping review of studies on employer use of health claims data.

Main Methods:

• A stepwise scoping review (ScR) framework was employed, including literature searches in PubMed and Embase.
• Forty-one studies of self-insured employee populations conducted by employers up to May 2022 were included.
• Data were charted and collated, with many studies supplementing claims data with human resource information.

Main Results:

• The majority of included studies (90%) used cohort designs, with employers primarily from aluminum production and health insurance sectors (51%).
• Fifty-nine percent of studies combined claims data with other sources to assess programs and health outcomes.
• Regarding privacy, 68% of studies reported Institutional Review Board approval, and 48% used deidentified data.

Conclusions:

• Self-insured employers leverage employee health claims data to understand employee needs and healthcare utilization.
• These insights can inform targeted wellness programs, aiming to enhance employee health and reduce absenteeism.