Meaningful and Purpose-Driven Results
STARTING WITH PROCESS EXCELLENCE
The Health Employer Exchange is about deriving value for our employees through process excellence and is focused on better results, including service for employees that will reduce the burden of chronic disease and consequently reduce cost and increase satisfaction. Lower cost is an outcome of excellence, not an objective in and of itself.
INCREASING ENGAGEMENT WITH INCENTIVES
Participants have consistently increased engagement (Principle B: Specifics of the Value-Based Care “Person Journey” that increase employee/enrollee engagement and adherence) and have adjusted incentives to produce this.
REPLICATING AND SCALING THE MODEL
Participants have specific favorable cost trend reductions and satisfaction increases by adapting and improving the Model and the Principles, and we are refining the ability to replicate and scale these across Participants systems and developing approaches to self-insured employers.
Cost Savings Results
15% reduction in costs
A 15% reduction in health plan costs over three years (when a 10%+ annual increase was projected)
5.4% reduction in claims
A 5.4% reduction in total medical and Rx claims paid in 2013 (University of Virginia Health System and Yale New Haven Health)
34% reduction in PMPM cost
A 34% reduction in PMPM cost with more than 770 participants, a reported satisfaction level of 99%, and a 75% positive goal progression rate
13% decrease in medical spend
A 13% decrease in medical spend for program participants vs. 8% increase for non-participants (from March 2016-2017)
Increased Engagement
Increased program volunteers
Improved engagement processes — starting at 300 program volunteers in 6 months at one health system and increasing to 1,600 program volunteers within 2 weeks at another
10% engagement growth
An 10% increase in engagement from 63% to 73% based on incentives evolution
Program Outcomes
20% reduction in ER visits
20% less ED visits, resulting in $2.4 million in savings
36% risk decrease from high to medium risk enrollees
15.5% decrease in pharma costs
15.5% decrease in pharma costs rate of increase from 19.4% to 3.9%
$787,000 current YTD pharma savings
$787,000 current YTD pharma savings by moving specialty drugs to 340b pricing
Physician Satisfaction
94% of physicians satisfied with program
65% of physicians believed chronic disease care improved
82% of physicians felt patients were more satisfied
65% of physicians reported time saved in calls, paperwork, and follow-up on referrals
Workers Compensation
28% lower claims cost than expected, resulting in $4 million in claims savings between 2012-2017
17% lower cost of subsequent claims during the program than expected, resulting in $1.12 million in claims savings over 44 months
18% fewer claims over 44 months
64% increase in engagement between 2015 – 2017