Submitter
Mary Delaney, President
Company
Vital Incite
Industry
Healthcare Consulting
Business Challenge
Health insurance is a valuable staff recruitment and retention tool for employers. But as healthcare costs continue to rise, employers and their benefit advisors must find more effective ways of reducing spend and improving health outcomes. Vital Incite partnered with one such employer whose annual expenditures for medical and pharmacy were increasing at a rate much higher than the national trend. In addition, the employer’s onsite clinic and related outcomes were falling well below expectations. To address these issues, the employer needed to reevaluate vendors and develop a more comprehensive, data-informed approach that would produce meaningful and measurable results.
Analytics Solution
In collaboration with the employer, benefit advisor, onsite clinic and healthcare providers, Vital Incite gathered all available data into a single, integrated database. A detailed analysis was then conducted to fully understand the employer’s historical spending trends, employee healthcare utilization and employee health status. In addition, Vital Incite analytics were applied to reveal the employer’s future risks for both health care spending and health outcomes. This actionable insight was then used to develop a coordinated, sustainable model for the employer that would mitigate prospective risks in order to reduce spend and improve health outcomes moving forward.
Impact
Within one year of instituting Vital Incite’s data-driven strategies, the employer was able to reduce plan spending and outperform the national market trend. The employer was also able to significantly mitigate costs by reducing the number of high cost claimants by 46%. Just as importantly, the insight gained through data analytics helped to identify risks and improve control of chronic conditions, like hypertension and diabetes, to further impact employee health and overall plan spend. The bottom line result of these data-informed strategies was that pharmacy spending declined by 35% per month while health outcomes for hypertensives and diabetics dramatically improved.