Case Study: Mid-Sized Manufacturer Intrductin Histrically, cmpanies have struggled with the best way t package and deliver benefits t attract talent and retain staff. Tday, cmpanies understand that they need t leverage a variety f slutins t prvide meaningful healthcare cverage, prmte wellbeing and mitigate cst. Vital Incite delivers data-driven strategies designed t identify medical spend waste and imprve efficient spend, allwing emplyers t reinvest in the crrect resurces that will imprve emplyee health. Fr this emplyer, data was the key cmpnent in crdinating effrts between the emplyer HR and C-suite, the advisr and the Ppulatin Health cnsultant. Key infrmatin unique t this emplyer Japanese wned and multiple natinalities emplyed with little knwledge f the American health care system ther than in the HR team Manufacturing cmpany with predminately male emplyees Onsite clinic pened April f 2014 with initial services including primary care, physical therapy, massage therapy, lab, nurse health caching Increase in medical plan participatin due t grwing wrkfrce and rich medical plan ffered at a lw cst t emplyees. Value f what was delivered Imprved risk migratin f high/very high risk members (ttal ppulatin and same chrt) Imprved efficiency f medical plan utilizatin and imprved unit cst Imprved care crdinatin (decreased ER visits, decrease in multiple medicatins, increase in number f members with a primary care physician) Targeted utreach frm nsite clinic t imprve verall health f members Prblem 1: Increase in medical plan spend Prir t the clinic pening, the medical plan saw utilizatin f ER visits and imaging services alng with assciated csts abve benchmark. The number f cvered lives (emplyees and spuses) was als increasing as well as the average emplyer paid amunt per member due t high cst utilizatin f an unmanaged wrkfrce. Current medical plans were tw lw deductible, PPO plans with little cnsumerism and ffered at lw cst t emplyees. Prblem 2: Lw nsite clinic utilizatin The first six mnths the clinic was pen shwed lw utilizatin fr several services resulting in the 1 P a g e
emplyer reducing services effective January 1, 2015 March 31, 2015 t help reduce csts. The suspended services included: patient advcacy, evening clinic hurs, reduced health caching hurs and physical therapy. In rder t fully recgnize the benefit f an nsite clinic, emplyees needed easier access t the clinic during wrking hurs; a better understanding f services prvided (i.e. labs, medicatins and nurse caching) and targeted utreach t key members. Prblem 3: Increase in risk migratin f member ppulatin Data revealed emplyees carried the majrity f the high/very high risk and risk migratin frm 2013 2014 shwed a neutral t slight increase (Figure 1). Further analysis shwed a higher than average percentage f untreated chrnic cnditins including diabetes, high chlesterl and high bld pressure. Cst infrmatin frm a disease perspective, shwed the ptential impact specific disease prgrams within the clinic culd have n emplyee health and medical cst. 2 P a g e
Analysis f Alternatives The data reprted frm the ppulatin health team was instrumental in develping a strategy t have an impact n the member ppulatin and a successful nsite clinic. Once there was an understanding f the prspective risk and impact f chrnic disease management by the emplyer C-suite, the HR team gained supprt fr the initiatives develped by the ppulatin health and HR teams. A key illustratin (Figure 2) t this pint was shwing a cst avidance calculatin fr key services prvided by the nsite clinic. Recmmended Slutin Imprve nsite clinic utilizatin: New hire physicals cmpleted at the clinic Emplyees allwed alltted number f visits per year n the clck t visit the clinic Benefits fair/clinic pen huse fr emplyees t get t knw the clinic staff Reduce the risk f emplyee ppulatin: Chrnic cnditin prgrams develped fr diabetes and high bld pressure: Diabetes prgram: members enrlled in the prgram where required t meet with the health cach and shw cmpliance with medicatin and Hgb A1c testing, in rder t receive free testing supplies. High bld pressure prgram: members enrlled in the prgram were required t meet with the health cach at least quarterly, have frequent bld pressure checks, and received maintenance medicatins fr free. Clinic utreach t high risk ppulatins: 3 P a g e
Multiple gaps in prescriptin cverage fr chrnic cnditins Uncntrlled, high risk bimetrics Additinal utreach N annual physical fr current year Multiple ER visits Reduce utilizatin and unit cst n medical plan: Emplyees were prvided with healthcare chices, educatin pieces and assistance fr price transparency Educatin emphasis was placed n chrnic cnditin maintenance and wellness activities Implementatin Once the initial strategy was develped, the emplyer HR, nsite clinic prvider, advisr and ppulatin health strategist met n a quarterly basis t review the fllwing key data pints: Risk migratin ttal ppulatin and same chrt (Figures 3 & 4) 4 P a g e
Care crdinatin including multiple ER visits, percent f individuals with primary care physicians and gaps in prescriptins fr chrnic cnditins (Figure 5) Clinic utilizatin and engagement including thse with high risk bimetrics engaged in primary care and health caching Annual physical exam cmpliance Year t date medical plan utilizatin and unit cst (Figure 6) As needed, strategy was adjusted t ensure the key bjectives were shwing prgress. 5 P a g e
Results As a result f the current strategies, the custmer has seen imprved health f emplyees, better medical plan spend and imprved utilizatin and efficiency with their nsite clinic. Further benefits fr each stakehlder include: Emplyer imprved utcmes with investments, identified and managed risks Emplyees imprved appreciatin f benefits and verall health awareness, less time away frm wrk Advisr/Ppulatin Health cnsultant data driven strategy and utcmes Cntact Vital Incite Tday! Vital Incite helps yu imprve health and lwer yur csts. Accurate riskscring enables ppulatin health managers t zer in quickly and effectively n high pririty cases. 250 West 96th Street, Suite 350 Indianaplis, IN 46260 P: 317.663.8302 E: mdelaney@vitalincite.cm www.vitalincite.cm 6 P a g e