Impacting Medical Costs and Outcomes, Using Integration and Data

A school association wanted to lower overall healthcare costs, improve employee health and well-being, and to obtain comparison results.

Solution

We offered a health and wellness program that helped increase engagement of employees with two major goals: improvement of key health measures – compliance with preventive care and screenings, recommended care for chronic conditions and medication adherence; and comparison of healthcare costs for employees who engaged in the program and those who did not participate.

Working to understand the association’s goals, the Health Advocate Wellness Program Consultant:
Collaborated with the client’s management team and, using data of all employees and family members who had a claim, developed a comprehensive program consisting of four health and wellness components to increase engagement as well as tracking analysis comparing employees who engaged vs. those who did not across a full year.

The health and wellness program components included:

  • Wellness with health and lifestyle coaching
  • Advocacy with data-based gaps-in-care coaching
  • Biometric screening with education on screening results
  • Personal Health Messaging with proactive gaps-in-care outreach

The comparison groups consisted of:

  • Members who received outreach letters only for a care gap but had no other contact with Health Advocate
  • Members who received a letter and also interacted with an advocate, coach or health educator at a biometric screening
  • Members who did not have a gap in care and had no engagement with Health Advocate
  • Enhanced reporting to provide comparison results. The Engagement Analysis Parameters included tracking for a full year based on the year before the Health Advocate program started as a baseline.

Results
Health Advocate provided a comprehensive program that resonated with employees and met the goals of the organization. Interacting with the program at any level improved compliance and reduced costs. Members in the “Engaged Group” (although older and sicker) had significant improvement in multiple clinical parameters compared to those in the “Letters Only” group.

Members in the Engaged Group experienced:

  • Higher compliance with preventive screenings
  • Higher compliance with recommended care for chronic illnesses
  • Fewer inpatient stays and ER visits
  • Better medication adherence for drugs related to chronic conditions

Overall Medical Cost Savings:
While the association’s total medical costs (PEPY) increased by 23%, the total medical costs for members who had any contact with Health Advocate increased at a much lower rate (13%), despite that this Group was more ill and at higher risk than the population that did not have contact with Health Advocate.

The 10 point difference in PEPY medical cost trend saved the association $4,868,200 per year ($1,010 PEPY x 4,820 employees).