Population health
5 Reasons Clinical Intervention Program Works: No Costs for Member Schools
Sep 13

According to a recent report from PricewaterhouseCoopers' Health Research Institute, medical costs will increase on average 6.5% in 2022. The report cites pandemic-related drivers for the jump: deferred care, exacerbated opioid and mental health crises, and an increase in unhealthy habits. Rising provider prices and market clout, skyrocketing prescription drug costs, and new expensive gene therapies will also push up rates.

Controlling healthcare and prescription drug costs are critical for sustaining effective, affordable healthcare benefits. In 2018, to support these goals edHEALTH introduced KnovaSolutions®, a comprehensive clinical decision support service that focuses on those who need the most help. The savings are compelling - the program saves $3.39 for every $1.00 spent. edHEALTH provides this resource to member schools at no cost.

Nineteen of our 23 educational institutions are taking advantage of this program. More than 340 employees and covered family members dealing with complex medical conditions are enrolled. These patients get the resources they need to feel better so they can go back to the things they love to do.

Twelve hours per day, participants can get answers to their medical concerns:

  • Help me understand my diagnosis, treatments, tests, and/or medications.
  • How can I make lifestyle changes?
  • Please review and help me understand my medications, how to take them, and whether I should be concerned about adverse interactions or side effects
  • How can I better balance work and life to support my loved one who’s ill?

The program ensures privacy while using predictive modeling to identify those in need of support early in their care journey. It’s effective due to a caring, coordinated, and comprehensive approach with a team reflecting 5 disciplines:

  1. Master of Science-degree nurses - are the main point of contact. They use a person-centric approach to conduct a comprehensive assessment, determine patient goals, develop a care plan, and enlist other team members as needed.
  2. Pharmacists – help members understand their prescription drug medications, ensure adherence, identify potential concerns, and give recommended cost-saving options.
  3. Certified diabetes specialist – supports patients with diabetes, provide ongoing education, and help patients navigate decisions and symptoms.
  4. Research librarians – discuss and send patients evidenced-based research about conditions, anticipated procedures, treatment options, risks, and benefits. They also find potential clinical research trials.
  5. Registered Dietician – the newest team member helps patients with a chronic disease and/or recently diagnosed condition with diet and lifestyle changes.

Enrolling in the program is easy. Member schools contact edHEALTH’s Cindy Bartelson to schedule a 30-minute kickoff call. KnovaSolutions provides the school with a suggested email to send faculty and staff. From there, KnovaSolutions does the rest, making it easy for school staff while protecting employee confidentiality.

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