Case Studies and Research

Case 1: Food Manufacturer
Company was concerned about the uncharacteristic 15% healthcare cost increase. The company immediately took action to improve performance but yielded a 5% reduction after two years. Believing that improving employee healthcare quality would further reduce costs, Med-Vision was hired to analyze cost drivers and recommend additional actions.
Med-Vision analyzed the employer’s data and identified ER visits and certain chronic diseases as top cost drivers. Med-Vision’s plan included wellness initiatives that provided education and awareness of disease management strategies and the importance of treatment compliance.
Med-Vision’s program addressed acute and chronic care trends and care management options. Diabetic counseling and one-on-one clinical consultations were established to review treatment plans, encourage lifestyle decisions to improve quality of life, coordinate services, and maximize benefits.

Results:
Success of the plan led the employer to open an on-site health clinic
PMPM pharmacy costs decreased 19.3%
Overall PMPM decrease
Inpatient days decreased
Generic drug use increased
ER visits decreased
Absenteeism decreased

Case 2: Regional School District
An 8,000 employee school district experienced rising medical spending trend. Med-Vision’s data analytics capabilities discovered chronic and co-morbid conditions, and preventive care non-compliance.
Med-Vision then designed value-based benefits and employee worksite wellness strategies to reduce the trend and the healthcare costs. Wellness visit copayments were eliminated to encourage preventive care and behavior change. It was determined that covering the cost of supplies for certain chronic conditions saved money. A wellness committee was established to communicate the value of healthy lifestyle choices and to deliver the wellness initiatives. Employees were rewarded for participating in education programs with lower copayments and subsidized supplies.

Results:
Healthcare costs decreased 10 to 12% in two years.

Case 3: County Government
Healthcare costs were rising but the cost drivers and solutions were unknown. Med-Vision’s data analytics discovered that 3.8% of the employee population was diagnosed with cancer and that it was only one of the top five diagnoses driving costs. Inconsistency in treatment unit costs indicated huge variances in practice patterns. Utilization metrics also indicated that employees with cancer were ten times more likely to visit the Emergency Room, and not comply with recommended cancer prevention screenings.
Med-Vision partnered with Biologics, a cancer management service provider, and a diagnosis and treatment service to establish a new care management approach. Pharmacological treatments were compared to national treatment practice guidelines to ensure correct therapy was used.
Med-Vision’s identification of unit cost of member care, and medical and pharmaceutical cost and quality trends data, identified costs and compliance improvement areas.

Results:
The county experienced an 8.6% PMPM cost decrease and a 38% improvement in breast cancer screening compliance. Because employees received the right care at the right time, care quality improved and costs declined.

Case 4: Cancer Treatment Center
A nationally recognized cancer treatment center earned the CEO Cancer Gold Standard™ certification awarded to organizations meeting high standards for cancer prevention, screening, and care for employees and family members.
Med-Vision supported the cancer treatment center’s commitment by developing an integrated benefit design approach to promote wellness initiatives, preventive screenings, and on-site clinics.
Med-Vision’s data analytics explored the impact a wellness management program would have on costs and quality of care. Higher costs were driven by inpatient admission, ER visits, and co-morbid conditions. The costs associated with depression were also determined.

Results:
Implementing a wellness management program increased the cancer treatment center’s preventive care compliance, provided education on depression screening, and reduced overall employee population risk. The cancer treatment center reported zero trend over two years, avoiding the previous trend of an average 12% annual increase. Published December 14th 2009