Employer Case Studies
A global manufacturer partnered with a vendor who specializes in combatting metabolic syndrome and insulin resistance to tackle the rise of prediabetes and diabetes in their population. Before rolling out the program to their population at large, they conducted a pilot program with a small group of employees with confirmed metabolic syndrome. The pilot resulted in clinically significant outcomes and at least $1,466 per member per year (PMPY) clinical cost savings. Out of 112 pilot participants, more than 90% completed the program and of those who completed a second biometric screening, the majority (77%) normalized at least one high-risk factor.
As a result of the successful pilot, the program was rolled out to the entire population with an expansion to include those with even just one metabolic syndrome risk factor. This 120-day intervention includes receipt of a scale and a Fitbit with cellular functionality, transmitting information to a coach. Based on information received, the coach works one-on-one with individuals on nutrition, physical activity, sleep and stress management. Interaction with the coach is telephonic or through video.
Success is driven by keeping the vendor accountable as they are compensated only if members are successful, as defined by normalizing at least one risk factor. To date, 80% of employees have met this success metric. (See Role of Key Stakeholders)
Over the past six years, a multi-state life and investment company has evolved its value-based benefit design with a laser focus on achieving measurable outcomes and favorable results. Their strategy started as a diabetes medication therapy management program including pharmacist consults and drug co-pay discounts. It has progressed to include a comprehensive health plan design for people with type 1 and type 2 diabetes with waived or reduced out-of-pocket member costs for eligible diabetes related medical services, testing supplies, drugs and medication therapy management. Success is measured by the increased use of high value medical services, improved drug adherence, favorable cost trends and reduced adverse events including emergency room visits and admissions from diabetic complications. (see Value Based Benefit Plan Design)
A mid-size manufacturer with a diverse, predominantly male employee population partnered with a local ethnic grocer to counter the negative social determinants of health plaguing their employees including accessibility to affordable nutritious foods. As part of a total population health approach, they launched their very own "Green Apron" program, a healthy meal preparation service that provides a once-a-week healthy meal that serves a family of four for under $20. Employees can choose from three healthy meal options – they receive the meal fixings and recipes, all packaged and ready to take home at the end of the workday. The employer works with their onsite wellness provider to develop weekly menus/recipes and the onsite cafeteria features a Green Apron meal once per week. Participation in the program continues to grow as a result of word of mouth, a comprehensive communications campaign and weekly raffle prizes for participants.
University of Chicago Medicine began a pilot program in July 2020 with limited participation eligibility to its more than 5,000 PPO members, plus spouses and children over 18 years old. Exclusive provider organization (EPO) plans were excluded from the initial pilot as they did not have a direct contract with the National DPP vendor. The National DPP lifestyle change program is offered as a covered medical benefit through a vendor that has a direct contract with their preferred provider organization (PPO) provider and can bill the program as a medical claim. Outcomes: 288 participants, about $205,000 in savings and 1,791 pounds were lost. The employer offered incentives, which were budgeted into the program costs for long-term sustainability, that enhanced employee engagement. The lifestyle change program has a 93% satisfaction rating from participants, with a lesson completion rate of 83.5%. View Case Study.