Best Practice gt90 Case Utilization Average case utilization with just Core Advocacy 11 Add Benefits Gateway and average utilization increases to 17 Integrate EmpoweredHealth ID: 647973
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Slide1
Bending the Cost Curve
A Case for Integration Slide2
Best Practice:
>90% Case Utilization Average case utilization with just Core Advocacy: 11%Add Benefits Gateway and average utilization increases to 17%Integrate EmpoweredHealth and Wellness and see engagement jump to 40%These numbers can be much higher depending on the number of services added to the mixBest practices like targeted incentives, outbound calling and home mailings all increase the effectiveness of your health and wellness programs driving greater than 90% case utilization
2
Advocacy
11%
Benefits Gateway
17%
Integrated Offering
40%
Driving Engagement
A Case for IntegrationSlide3
Proprietary algorithms
leverage data to drive member and group health improvementLeveraging DataOur comprehensive clinical modelAnalyze data to identify gaps in careApply data in personal member interactions and via member dashboards to close care gaps3Slide4
4
Advocacy11%Benefits Gateway17%Integrated Offering40%Data Integration
Impacting Medical Costs
A Case for Integration and Data
Best Practices
Increase ROI from 2:1 to 9:1
Advocacy:
Gaps in care coaching to improve compliance with preventive care and screenings, evidence-based recommended care for
chronic conditions and
increase medication adherence Benefits Gateway increases opportunities to close gaps in care by 200%
Adding Wellness, Personal Health Messaging and
Chronic Care Solutions achieves incremental impact on medical costs.
Best practices
like remote monitoring of diabetics, outcomes-based incentives and targeted outreach result in
twice the PEPY Savings
and the
greatest ROISlide5
easier
drives better resultsThe numbers speak for themselves In 2016 Health Advocate Achieved:2.5 million Interactions (calls & cases)$60 million Value of gaps in care closed$168 million
Productivity
s
avings
3:1
ROI
savings EmpoweredHealth
c
lients 9:1 ROI
Best Practice
Over
10,000
Member compliments
Up to $531
PEPY
Savings
(engaged
vs.
non-engaged members)
5Slide6
Eliminate
4 - 7 vendorsIntegrate data across vendors One integrated reportOne bill
Average
engaged:
40
%
(Best Practice
>90%)
• Close >
50% care gaps
Over
2
years,
the medical cost trend for
members
who interacted with Health
Advocate
was
28
%
lower
than
for those who did
not
engage with
us
Average:
110%
-
120%
EmpoweredHealth:
ROI increases to
120%
-
130%
Lower
Administrative Costs
Higher
Engagement
Better
Outcomes
Return
On Investment
easier drives
better results
6Slide7
Case Study
Impacting Medical CostsSlide8
Case Study: School Consortium
(50 schools, 10,000 employees)In an effort to lower overall healthcare costs and improve employee health and well-being, the Consortium implemented a multifaceted Health and Wellness program. The program achieved a 9:1 Return on Investment. The program consisted of four health and wellness components:Wellness with health and lifestyle coachingAdvocacy with data-based gaps in care coachingBiometric screenings with health education on screening resultsPersonal Health Messaging with proactive gaps in care outreach8Slide9
Case Study: School
ConsortiumCase Study GoalsCompare healthcare costs for employees who engaged in the program and those who did not participate Examine the impact of the program on key health measures:Compliance with preventive care and screenings Recommended care for chronic conditions
Medication
adherence
9Slide10
10
Case Study: School ConsortiumEngagement Analysis ParametersThe analysis tracked health outcomes over a full year using the year before the Health Advocate program started as a baseline.Baseline year -12/1/2014 - 11/30/2015Current year - 12/1/2015 - 11/30/2016Data included all employees and family members who had a claim and were continuously covered for health benefits by the ConsortiumComparison GroupsLetters Only: Members who received outreach letters for a care gap but had no other contact with Health Advocate Engaged Group: Members who received a letter but also interacted with an advocate, coach or health educator at a biometric screening Control Group: Members who did not have a gap in care and had no engagement with Health Advocate Slide11
11
Case Study: School ConsortiumKey FindingsInteracting with the program at any level improved compliance and reduced costsMembers in the “Engaged Group” (although older and sicker) had significant improvements in multiple clinical parameters compared to those in the “Letters Only” group Members in the “Engaged Group” experienced:Higher compliance with preventive screeningsHigher compliance with recommended care for chronic illnessesFewer inpatient stays and ER visitsBetter medication adherence for drugs related to chronic conditionsSlide12
Case Study: School Consortium
Overall Medical Cost Savings The Consortium’s total medical costs (PEPY) increased 23%The total medical costs for members who had any contact with Health Advocate increased at a much lower rate (13%), despite the fact that this group was more ill and at higher risk than the population that did not have any contact with Health AdvocateThis 10-point difference in PEPY medical cost trend saved the Consortium $4,870,8991210-point lower cost trend for the group who had any contact with Health Advocate = $1,010 PEPY= $1,010 x 4,820 employees= $4,870,899 savings per yearSlide13
Case Study: School Consortium
Savings Summary$4,870,899 per year ROI of 8.9:1 (nearly nine times the cost of Health Advocate’s programs)13