Population health initiative reaps better care and value
For the First Time, Plan Designs Informed by High-Performance Analysis
Dec 14

One of edHEALTH’s strategic initiatives is population health – working together to improve our member schools’ faculty, staff, and family health outcomes to bend the healthcare cost curve. Almost three years ago, we contracted with HCMS, our data warehouse now called Workpartners, to provide a person-centric clinical program for patients with complex healthcare needs. This year, Workpartners began analyzing edHEALTH’s data for plan design purposes. These initiatives are translating into quantifiable results for our member owners and their employees.

“What started as a need for data warehouse capabilities has grown into a strategic partnership for making data-driven decisions,” said A. Tracy Hassett, edHEALTH’s president and CEO.

2021 Plan Designs Informed by In-Depth Analysis

In the spring, Workpartners conducted a deep dive into edHEALTH’s suite of plan design options. This analysis compared the monthly cost per unit of risk across the plans. Based on this analysis, Workpartners identified the best combination of plan design and employer Health Savings Account contribution. “This analysis allowed schools to see where they’ve been, where they are compared to the edHEALTH captive, and where they should consider design changes to maximize their healthcare dollars,” said Stacie DeHerrera, Account Executive at Workpartners.

Member institution, Worcester Polytechnic Institute, used this analysis to launch a new plan design that is cost-effective for the school without pushing costs onto their employees. edHEALTH and WPI will be monitoring this plan throughout the year to see how it performs. That analysis coupled with Workpartners’ 2021 annual plan performance analysis will help guide other member schools and their advisors in their 2022 plan design choices.

New Customized School Reports Introduced

In response to member school and their advisor requests, edHEALTH collaborated with Workpartners to develop additional school-specific reports. This information will help schools and their advisors benchmark performance against the edHEALTH captive. Distributed for the first time last month, these quarterly reports provide cost trend insights. The school-specific data gives our owners and their advisors the power to benchmark their performance against the captive to identify best practice, design, policy, and wellness opportunities.

Schools enrolled in the KnovaSolutions® care management program will also receive in early 2021 individual school reports on this program’s performance. To date, inpatient stays have dropped 31%, and emergency room visits have decreased 30% across all participating schools. Although some of this change is due to COVID-related deferral of care, these results are much better than edHEALTH’s overall hospitalization and emergency room trends. The KnovaSolutions program is a personal health service for people experiencing difficult medical concerns. Patients use the services to get the resources they need to feel better so they can go back to the things they love to do. The Return on Investment is compelling: the program saves $4.54 for every $1.00 spent, which equates to over $672,000 in net savings for the schools and the enrolled patients.

“Our population health initiative gives us the tools we and our member institutions need to make informed, data-driven decisions that improve care and reduce costs,” said Tracy. “The companion clinical assistance program helps the employees and their family members who need it most.”

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