What’s a point solution?

Most firms offer programs to identify health issues and manage chronic conditions (health risk assessments, biometric screenings, and health promotion programs).

83% of large firms offer a program in at least one of these areas: smoking cessation, weight management, and behavioral or lifestyle coaching.

Source: Kaiser Family Foundation study

Use a cohort strategy to evaluate point solutions.

Cohort comparisons are the ultimate analytic strategy for proving value. Without a direct comparison within the same population, there are so many factors that introduce doubt on what the numbers truly capture. Alternatively, by looking at well defined and specifically differentiated groupings of people, we can directly compare performance take away concrete and specific learnings.

1. TIP: Look at related costs across your cohorts: Determine if there is value beyond just the immediate program financials. For instance, we have looked at disability claims, to measure the influence of a point solution program.
2. TIP: Look at related health concerns: Investigate other aspects of wellbeing to see if there are notable halo effects.  For instance, we have investigated if there are mental health differences across maternity program types, short and longer term.

Here’s a good example from our client base: This national retailer wanted to measure the value of a Center of Excellence strategy for heart conditions.  The metric strategy compared a well-defined pair of cohorts that looked beyond traditional utilization and cost metrics.  We helped them also include mortality rates (COE – lower), returns to work (COE – faster), outcomes (COE – better), and company satisfaction (COE – higher).  Yes, that’s right – employees actually reported a higher employee satisfaction rate on the survey following a major episode of care.

Ask the right analytic questions.

Often “What’s the value?” is the wrong question. The correct question is “Who is this valuable for?” or “What’s the incremental value?”

There will always be a portion of a population that is engaged in their health and wellness. Your data can tell you who this population is, and provide insights that help you identify more people “like them” that you can target and pull along, therefore increasing program value. Also consider if the engaged audience would have been healthy or well without the special program, in some other way. Is it the program – or the people – that are providing the results you see?

Use ALL the data we have available in today’s analytic world.

Understand how social determinants of health influence engagement and utilization.  Then optimize the point solution to meet broader needs by removing barriers.  The data can show you where actions will be impactful.

Data that provides insights into social determinants of health can be time consuming to assemble into an analytic environment and then align to member health data. And yet it’s so powerful for insights. Your analysts time is better spent using this data as opposed to prepping it manually.

We evaluated medical and dental claims for diabetics after the introduction of a new Virtual PCP program.  The solution was selected after seeing a statistically significant difference in PCP utilization across various household income segments.  We created a specific scope around diabetics to study impacts on utilization, medication adherence, medical costs, and co-morbidities in mental health.  Not all investigation can rely solely on data.  The task force team worked with “Voice of the Member” groups, formed based on specific demographics. They focused on understanding context and color behind the numbers.  Transportation, time away from work, and caregiving themes arose in the care access category.  Other reasons were also presented, but offered less immediately actionable solutions.

With less time prepping data, the team had more time to dig deep, address quantified specific barriers, and is now measuring impact.