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Self-Funded Medical Client Case Study

HRA FSA and Wellness Solutions Case Study on Hospital in NY

Solutions Set - WELLNESS

Challenge

This client has always been committed to the health and wellness of its workforce. Recently, however, results were unsatisfactory. Its disease management vendor managed an opt-in model netting a participation rate of just 14%. Consequently, the company sought a trusted partner to assist in the move to a consumer driven approach.

Solution

The Steps to Success program offered a proactive model that would target the individual and provide a customized approach to wellness. Implemented to provide a population health approach for members, the innovative program focuses on individual claims data to deliver customized member wellness and disease management services. In fact, Steps to Success delivers a participation rate of greater than 99%, which means that less than 1% opt out.

Results

  • Cancer Screening Rates Up: Rates climbed to expected commercial norms for colon cancer screening and mammography.
  • Cancers & Pre-Cancers Identified Early: A total of 84 cancer or pre-cancer cases were identified. A total of 87.5% of these cases were found early and cost less than $8,000 apiece to treat.
  • Total Savings from Such Identification: Early detection saved the plan more than $700,000.
  • Increased Utilization of Preventive Health Services: Program successfully encouraged members over 40 who had not been to a primary care physician in a year or more to see a doctor. More than half of the members targeted visited doctors, identifying many health issues that may have gone undetected until more advanced and costly to treat.

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