Large Health Plan Saves Nearly $60 Million With Health Dialog


We can all agree that controlling medical costs and improving quality of care is a common goal among healthcare organizations. But, without the proper tools in place, few are set up to actually achieve this objective.

One of Health Dialog’s longstanding clients, a roughly 3-million-member health plan, realized this several years ago and implemented our integrated population health management solutions to help control medical costs, improve member and employer satisfaction and engage high-risk populations to improve health outcomes. In a three-year analysis of this partnership from 2013 to 2015, the health plan made significant progress on each of these goals, and achieved nearly $60 million in medical cost savings.

The health plan leveraged several of Health Dialog’s tools, including:

  • Data Management and Analytics: Health Dialog’s proprietary analytics and predictive models helped the organization turn disparate data sources (e.g. HRA, medical and pharmacy claims, lab data, coach-captured data, etc.) into actionable and comprehensive member profiles.
  • Chronic Disease Management: Health Dialog’s Chronic Care Management solution delivers personalized interventions to help members manage and slow the progression of chronic conditions, such as cardiovascular disease, chronic obstructive pulmonary disease (COPD), diabetes, hypertension, and asthma.
  • Wellness Program: Health Dialog’s wellness program cultivates a healthier population by providing members with information on health risks related to tobacco use, high glucose, high blood pressure, body mass index (BMI), nutrition, stress and physical activity.
  • 24/7 Nurse Line: With the health plan’s diverse population, it was crucial that members had access to a bi-lingual nurse line 24/7. Having the ability to speak with nurses about non-emergency health problems dramatically reduced the number of unnecessary ED visits.

Further, health plan members with cardiovascular disease in contact with Health Dialog coaches through its Chronic Disease Management solution avoided 2.5% of sentinel events (i.e. AMI, stroke, heart surgery), and those who eventually reached a sentinel event did so 600 days later those who did not work with our health coaches. Additionally, members with program contact were also 18 percent slower to advance to the next disease stage, for example from an early or late “progressive” stage to a “critical” condition (see Health Dialog’s Delaying Disease Progression Whitepaper) on the cardiovascular disease pathway. An early progressive state happens after the condition is diagnosed and means that the population demonstrates an intensification of treatment or disease burden. Late progressive means they’re one step away from being critical and that they show significant long-term impacts from the medical condition.

In addition to generating cost savings of nearly $60 million in 3 years, the health plan received positive feedback from members who were impressed with the quality of educational material and level of customer service through the 24/7 nurse line and health coaches. With Health Dialog’s partnership, the plan is well-positioned to further engage its unique population, continually improve care and lower medical costs throughout the organization.

View the case study infographic for a snapshot of the finanical, clinical, and member satisfaction results achieved by this health plan.

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