Realize ROI by Improving Chronic Condition Management

Did you know that, on average, the sickest 4% of the population represents 41% of the total allowed medical and pharmacy spend? It’s hard to believe -- and even harder to manage. That’s why we created Mercer Health AdvantageSM (MHA), a proprietary, high-intensity care management program designed to manage care for employees with serious/chronic conditions -- and we’ve seen some great results. In fact, according to a study released this week, employers who offered MHA realized a combined average return on investment* of $2.70 in health care savings for every $1 spent.

Further, our analysis showed average annual savings of $338 per employee along with significant improvements in the quality of care for the most ‘at-risk’ patients. Based on 2014 clinical results, there was a much sharper decrease in hospital admission rates for the MHA-engaged (-18%) compared to the non-engaged (-5%) population.

MHA drives coordinated patient engagement -- at the right time, with the right providers. Individual health plan programs vary, but the core MHA model is based on a single registered nurse from a given health plan working with a dedicated team of other specialty clinicians, including social workers, pharmacists, physicians, and behavioral health specialists from the plan to coordinate patient care. This holistic, high-touch approach encompasses not only clinical care, but also addresses such important issues as spousal/family involvement, mental/psychological monitoring, and post-care monitoring.

Be sure to check out this case study to learn how a large aerospace company used Mercer Health Advantage to better control costs and improve patient outcomes.

*ROI is based on an analysis of claims data and program activity. Various best-practice methods are used to estimate savings from avoided costs attributable to program activity. The Mercer Health Advantage service was available through Aetna, Anthem, HCSC and UHC in 2014, and, as such, the ROI result herein is based on their combined performance.

Linda Hull
by Linda Hull

Leader, Mercer Health Advantage, Mercer

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