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Create Cost-Saving Initiatives to Optimize Plan Design

Employee Benefits, Healthcare

Over the past few years, employers have increasingly looked for resources and targeted outreach that can improve the health and well-being of their employees.

CLIENT:

Healthcare system client

ISSUE:

Diagnose

A healthcare system client of M3 wanted to engage internal resources to actively promote a culture of well-being throughout their organization. The M3 team, with the assistance of their client’s HR and clinical teams, reviewed data curated to determine what interventions and clinical pathways they could develop. Additionally, they captured some utilization metrics the client’s leadership wanted to track and integrated that into their reporting.

Measure

The client provided M3 with savings goals derived from their Dataffect partnership for each of those four conditions. With the savings goals in hand, the team created focus populations (cohorts) for each of the condition groups to track their spend year-over-year. To add another layer to their reporting, M3 created a scorecard that could be updated monthly. In addition, they worked to create a custom report with all metrics that they were tracking for easy, ad-hoc analysis.

IMPACT:

Plan

Once the clinical initiatives were identified utilizing data, M3 worked with the client’s clinical team to develop a tailored outreach process for members who could be positively impacted by engaging with a nurse. Specifically, they focused on closing members’ gaps in care when they were diagnosed with one of four specific conditions (diabetes, coronary artery disease (CAD), high cholesterol, and medication management).

Evaluate

While still in the first year of these initiatives, M3’s client is thrilled that they can quickly determine where they stand compared to budgeted savings on the focused initiatives. Furthermore, M3 can easily pivot and reset expectations due to their ability to access this data monthly and determine where there are outliers. With the support of their client’s clinical team, M3 can adjust to the targeted population and outreach process to drive engagement and continue enhancing their culture of well-being.

By leveraging data, we are able to drive actionable, targeted strategies with our clients. Not only can we identify the greatest opportunities for intervention, but we can measure the effect we are having to positively impact the health of the population and help control cost long term.

— Brian Meyer
Director of Analytics & Underwriting
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