Bending the Cost Curve
A Case for Integration
Driving Engagement
A Case for Integration
Advocacy
11%
Benefits
Gateway
17%
Integrated
Offering
40%
Best Practice: >90% Case Utilization

Average case utilization with just Core Advocacy: 11%

Add Benefits Gateway and average utilization increases to 17%

Integrate EmpoweredHealth and Wellness and see engagement jump to 40%

These numbers can be much higher depending on the number of services
added to the mix

Best practices like targeted incentives, outbound calling and home mailings all
increase the effectiveness of your health and wellness programs driving greater
than 90% case utilization
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Leveraging Data
Our comprehensive clinical model
Proprietary algorithms
leverage data
to drive member and
group health improvement
Analyze data
to identify
gaps in care
Apply data
in personal member
interactions and via
member dashboards
to close care gaps
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Impacting Medical Costs
A Case for Integration and Data
Advocacy
11%
Benefits
Gateway
17%
Integrated
Offering
40%
Data
Integration
Best Practices Increase ROI from 2:1 to 9:1

Advocacy: Gaps in care coaching to improve compliance with preventive care
and screenings, evidence-based recommended care for chronic conditions
and increase medication adherence

Benefits Gateway increases opportunities to close gaps in care by 200%

Adding Wellness, Personal Health Messaging and Chronic Care Solutions
achieves incremental impact on medical costs.

Best practices like remote monitoring of diabetics, outcomes-based incentives
and targeted outreach result in twice the PEPY Savings and the greatest ROI
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easier drives better results
The numbers speak for themselves
In 2016 Health Advocate Achieved:
2.5 million
$60 million
$168 million
Interactions
(calls & cases)
Value of gaps in
care closed
Productivity
savings
Up to $531 PEPY
Savings (engaged vs.
non-engaged members)
Over 10,000
Member
compliments
3:1
ROI savings
EmpoweredHealth
clients
9:1
ROI Best Practice
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easier drives better results
Lower
Administrative Costs
• Eliminate 4 - 7 vendors
• Integrate data across
vendors
• One integrated report
• One bill
Higher
Engagement
• Average engaged: 40%
(Best Practice >90%)
• Close >50% care gaps
Better
Outcomes
• Over 2 years, the
medical cost trend for
members who
interacted with Health
Advocate was 28%
lower than for those
who did not engage
with us
Return
On Investment
• Average: 110% - 120%
• EmpoweredHealth:
ROI increases to
120% - 130%
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Case Study
Impacting Medical Costs
Case Study: School Consortium
(50 schools, 10,000 employees)
In an effort to lower overall healthcare costs and improve
employee health and well-being, the Consortium
implemented a multifaceted Health and Wellness program.
The program achieved a 9:1 Return on Investment.
The program consisted of four health and wellness
components:
 Wellness with health and lifestyle coaching
 Advocacy with data-based gaps in care coaching
 Biometric screenings with health education on
screening results
 Personal Health Messaging with proactive gaps in
care outreach
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Case Study: School Consortium
Case Study Goals
1.
Compare healthcare costs for employees who engaged
in the program and those who did not participate
2.
Examine the impact of the program on key health
measures:
 Compliance with preventive care and screenings
 Recommended care for chronic conditions
 Medication adherence
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Case Study: School Consortium
Engagement Analysis Parameters
The analysis tracked health outcomes over a full year using
the year before the Health Advocate program started as a
baseline.
 Baseline year -12/1/2014 - 11/30/2015
 Current year - 12/1/2015 - 11/30/2016
 Data included all employees and family members who
had a claim and were continuously covered for health
benefits by the Consortium
Comparison Groups
1. Letters Only: Members who received outreach letters
for a care gap but had no other contact with Health
Advocate
2. Engaged Group: Members who received a letter but
also interacted with an advocate, coach or health
educator at a biometric screening
3. Control Group: Members who did not have a gap in
care and had no engagement with Health Advocate
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Case Study: School Consortium
Key Findings


Interacting with the program at any level improved
compliance and reduced costs
Members in the “Engaged Group” (although older and
sicker) had significant improvements in multiple
clinical parameters compared to those in the “Letters
Only” group
Members in the “Engaged Group” experienced:




Higher compliance with preventive screenings
Higher compliance with recommended care for chronic
illnesses
Fewer inpatient stays and ER visits
Better medication adherence for drugs related to
chronic conditions
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Case Study: School Consortium
Overall Medical Cost Savings
• The Consortium’s total medical costs (PEPY)
increased 23%
• The total medical costs for members who had any
contact with Health Advocate increased at a much
lower rate (13%), despite the fact that this group was
more ill and at higher risk than the population that did
not have any contact with Health Advocate
This 10-point difference in PEPY medical cost trend
saved the Consortium $4,870,899
10-point lower cost trend for the group
who had any contact with Health Advocate
= $1,010 PEPY
= $1,010 x 4,820 employees
= $4,870,899 savings per year
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Case Study: School Consortium
Savings Summary

$4,870,899 per year

ROI of 8.9:1 (nearly nine times the cost of Health
Advocate’s programs)
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