UnitedHealth Group Inc. saved more than $100 million in medical costs over three years by using incentives to persuade its employees to get healthier.
Nearly 80 percent of its employees reduced their family insurance premiums by losing weight and meeting certain other health goals in just the first year of the program. Twenty-seven percent achieved the highest possible savings, cutting their premiums by $1,200.
The largest health carrier in the U.S. employs 133,000 workers. Its program identified 7,200 people who were at high risk for diseases, including diabetes, but hadn’t been diagnosed.
After reviewing its own data and experimenting with an array of programs, UnitedHealth said it believes plan providers too often take a passive role in cost-containment, something that has to change if the health care system is to be mended. Payers, too, have a bigger role to play, it said.
The three authors of the patient engagement study — Simon Stevens, president, global health, UnitedHealth Group, Lewis Sandy, a UnitedHealth Group EVP, and Reed Tuckson, managing director, Tuckson Health Connections — reviewed massive amounts of data and reports produced by UnitedHealth’s patient engagement initiatives.
Here’s some of what they wrote:
“Many proponents of delivery system transformation have framed patient engagement in terms of what providers can do with their patients, without considering the role of payers. Some might suggest that the payer’s role is simply to offer a network and a benefit package and let the work of patient engagement occur exclusively between health professionals and patients.
“Our view, however, is that although the patient-physician relationship is central to health care, payers will play an important and complementary role in enabling robust patient engagement and achieving the ‘Triple Aim’ — a better patient experience, improved population health, and lower per capita costs.”
Among the UnitedHealth initiatives they cited in the study:
HealthNotes: Launched in 2009, it is a health alert messaging system designed to address and close gaps in a patient’s health regimen. UnitedHealth reviews patient data from a variety of sources, analyzes them for potential gaps such as missed screenings opportunities, and “reaches out to patients via mail, phone, text message, an online portal, or some other means of the patients’ choosing.” HealthNotes is used with 14 million UnitedHealth customers. “When compared to a control population, consumers and their physicians who receive these messages closed 64 percent more gaps related to medical management and 30 percent more gaps related to missed therapy over a three-month period.”
Baby Blocks: “A reminder system that engages low-income pregnant women during their pregnancy and in the first 15 months after delivery. Under this program, which began in 2011, women receive personalized reminders via cell phone along with incentives to encourage prenatal and well-child visits in alignment with professional standards. The program is operating in nine states served by UnitedHealthcare’s Medicaid plans.”
Treatment Decision Support: UnitedHealth partnered with a sister company, Optum, to create “treatment decision support programs” in nine clinical areas. Launched in 2006, the program now covers some 16 million plan members.
“Optum provides care management, home visits, a nurse hotline, and other clinical support services to payers, employers, and health systems. Specially trained Optum nurses elicit patients’ preferences and values, typically through inbound or outbound telephone calls. They advise patients on their treatment options and how to communicate more effectively with physicians and other care providers.”
Results have been outstanding, the study reports. Among the outcomes: “25 percent of patients who engaged with the program ultimately selected a more conservative, evidence-based treatment than was originally proposed, with savings per treatment of more than $11,000, on average.”
UnitedHealth Premium Designation: Unveiled in 2005, this initiative was designed to gather and crunch data on 240,000 U.S. physicians in 21 specialty areas. Those physicians who received high marks for efficiency and quality “have a 14 percent lower cost per episode on average, compared to non-designated physicians.”
The study cited more programs targeting greater patient engagement in their own healthcare, and reported that UnitedHealth’s own internal engagement program saved the company an estimated $107 million in group healthcare costs compared to industry averages.
“Payers are uniquely positioned to use their data and analytic resources to identify care opportunities for patients and their care providers and to share that information. Because payers have data on variations of quality and efficiency among care providers as well as the capacity to identify high-risk people and situations, such as duplicative drug orders and patients who see multiple physicians without evidence of care coordination, they can offer decision support services and other information to help inform care choices,” the authors concluded.