LMR Health
LMR HEALTH CASE STUDY - ROI
LMR Health Case Study - Employee Population
Target Population Description
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Employees of a regional medical center
Objective/Goals
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Modify lifestyle related conditions that are responsible for 30 percent of the company's medical costs
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Reverse upward trend in health care spending
Linkages to Follow-up Programs
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Telephonic health line for counseling on fitness, nutrition and preventive health issues and receiving general health, medical self-care information and wellness newsletters
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Physician referral for high-risk individuals
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Case management for smokers and overweight (20%) and underweight (20%) individuals
Results/Measures
The program was implemented at the beginning of a benefits cycle
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23,621 employees were covered by the company's health plan, 84 percent elected to participate in the program. (The majority of participants did not fall into a high-risk category or require referral to a physician, however everyone gained access to the interventions, education and support for healthy lifestyles)
After the assessment
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3.4 percent were identified with conditions requiring a referral to a physician
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13.2 percent were identified with high-risk factors that had been associated with lifestyle-related illnesses
After six months
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12.6 percent of the case managed group had met their goals by the end of year one
By the end of year
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36.3 percent had met their goals for a total of 50 percent
Financial Impact
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Lifestyle related claims dropped that year by $1.1 million
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Medical claims overall fell 9 percent, saving the company $5 million
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Cost per employee trended downward, dropping 5 percent
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Inpatient utilization decreased 21 percent per 1,000 lives
These reductions occurred in spite of additional benefits of nearly $9 million that were added to the employees health plan (i.e. prenatal, EAP, well baby care etc.) The following year's anticipated budget of $75 million was cut by $23 million to levels well below the previous years spending.
The annual cost for the program was $1.5 million. However, the employer actually recovered their entire $1.5 million investment in the program through contributions from non-participants. The additional $34 a month in health premiums paid by the 16 percent (3,773 employees) who elected not to participate in the program added $1,539,384 to the company's health benefits program. Through the contribution of the 16 percent the program's costs were fully recovered.
Discussion
The results of this study seemed to suggest that a well-planned program focused on better health risk management practices can make a systematic contribution to better health practices for the program participants. The results showed a Return on Investment (ROI) of over 400 percent based on a program cost of $1.5 million dollars and claim reductions of $6.1 million dollars.