Evidence Based Health Plan


health plan explanation

An Evidence Based Health Plan

You deserve an Evidence Based Health Plan. We provide clear performance metrics illustrating why a program built on Care Coordination lowers cost and delights plan members. In our presentation, we provide the sources for the data. For example, cost control and plan member change data come from a third party, study performed annually by one of the leading actuaries in the United States. The study is of the entire book of business for the Care Coordinator utilized in our program. It is representative of 300,000 plan members and 75 employers. The statistics we provide here are the averaged results, not a cherry-picked data set showing best performers.

Cost Control

Savings

8.6% Year 1 Average

15% Year 3 Average

Medical Trend Average

0.2% 2012-2104

Cost Control

Savings

8.6% Year 1 Average

15% Year 3 Average

Medical Trend Average

0.2% 2012-2104

Plan Member Behavior

  • 20% reduction in hospital readmission
  • 5% increase in primary care visits
  • 8% reduction in inpatient days
  • 3% reduction in inpatient days
  • 6% reduction in outpatient surgical visits
  • 8% reduction in ER visits

Plan Member Satisfaction

• 72 Net Promoter Score (Excellent) vs. average of 18 for health insurance industry.
• 94% plan member satisfaction

Net Promoter or Net Promoter Score (NPS) is a management tool that can be used to gauge the loyalty of a firm’s customer relationships. It serves as an alternative to traditional customer satisfaction research and claims to be correlated with revenue growth.[1] NPS has been widely adopted with more than two thirds of Fortune 1000 companies using the metric.[2]

• NPS can be as low as −100 (everybody is a detractor) or as high as +100 (everybody is a promoter).
• An NPS that is positive (i.e., higher than zero) is felt to be good
• An NPS of +50 is excellent.
• The health insurance industry has an 18 NPS, Apple has a 72, Amazon has a 68 and Netflix has a 68
• The Care Coordinator in our program has a 72 NPS

Cost Control

Savings to Claims
Our Care Coordinator
Average Year 1 8%
Average Year 3 15%
Lower Your Long-Term Medical Trend
2012-2014 2000-2014
Our Care Coordinator 0.2% 3.5%
Towers Watson Survey 4.2% 6.5%
Aon Hewitt Survey 4.9% 7.0%

Healthier People

Plan Member Outcome
Primary Care Visits +13.5%
Hospital Readmission -20.0%
ER Visits -8.0%

Happier People

Plan Member Experience
Net Promoter Score Satisfaction Rate
Our Care Coordinator 73 94%
Industry Average 18 51-67%