EP372: Step One for Employers and Unions—Get Your Data, With Cora Opsahl

Why Getting Your Own Claims Data Is Step One for Employers and Unions, With Cora Opsahl. Step One for Any Self-Insured Employer or Union: Demand Your Own Data. Episode 372.

Stacey Richter talks with Cora Opsahl, director of the 32BJ Health Fund, about why demanding full claims data from every vendor was the foundational move that let a 200,000-member union health fund make validated benefit decisions instead of guesses.

WHAT YOU'LL LEARN

✅ Why 32BJ Health Fund successfully demanded its own data from 100% of its vendors, and why a vendor's reluctance to share data is itself a red flag

✅ How having your own data lets a plan sponsor accurately model the cost of a new program instead of relying on a vendor's estimate

✅ Why communicating with the right members, using data, is essential to making a new benefit design actually succeed

✅ How siloed pharmacy and medical data can hide cost-shifting—for example, a PBM claiming savings while pushing costs onto the medical side

✅ Why ensuring you're not overpaying a bill (writing a check for more than was actually billed) is a surprisingly common, fixable problem with the right data

✅ How 32BJ's data use breaks into three categories: cutting wasteful spending and fraud, making smart benefit decisions, and forecasting trends for financial solvency

WHY THIS MATTERS

A self-funded plan cannot be a responsible fiduciary without its own data—guesses about cost, trend, and vendor performance routinely turn out wrong once a fund actually looks at the numbers. Opsahl's account of how 32BJ built this capability gives other employers and unions a concrete starting point: demand the data first, then build the analytics and decisions on top of it.

MENTIONED IN THIS EPISODE

EP285 with Dawn Cornelis: Apple Podcasts | Spotify | Other Apps

EP358 with Wayne Jenkins, MD: Apple Podcasts | Spotify | Other Apps

=== LINKS ===

🔗 Show Notes with all mentioned links: Episode Page

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00:00 Introduction.

08:55 How much data does 32BJ Health Fund have, where do they get it, and how do they use it?

10:56 How did 32BJ Health Fund successfully demand their data from 100% of their vendors?

11:45 "We feel it's really important that we own this information ourselves."

12:08 "It always concerns me—if a vendor doesn't want to give you the information, what are they hiding?"

12:34 "It's not just getting the data; it's then using the data."

15:44 "Without data, you're really just taking a guess; and guesses are never gonna get you where you need to go."

21:07 "The use of data has really built our knowledge."

22:55 "It's really important to us that as we make benefit decisions, we're doing it smartly."

27:42 How is 32BJ Health Fund making their data knowledge actionable?

30:14 "If we can figure out how to make telehealth accessible … there may be an opportunity for telehealth … to upset some of these … monopoly systems or low-choice options."

32:25 "It's really easy to think that we can solve this problem through benefit design … but in the end … it's the price."