Population Health Management: the better way to employee health.

• Author: Berenji, Manijeh
• Position: Business Guide 2016

As an employer, you want to keep both your employees and your bottom line in good shape. But it seems like the more robust your group health insurance policy is for your employees, the more you spend. Is there a strategy that can help you serve both your employees' health and your financial health?

Yes. Population Health Management is an approach to benefits management and employee health that helps employers understand the optimal combination of each. It's an innovative, data-driven strategy that helps you deal with your group health insurance costs by understanding your employees' health and working with them to improve it. A good Population Health Management strategy creates a win-win situation for you and your employees.

How does Population Health Management work?

Every business is different, but in general, a good strategy will first work with comprehensive claims data from companies' insurance plans to identify high-cost claimants. Once you truly understand the issues that are taxing your resources, like diabetes, cancer or back pain, you can develop strategies to help employees be healthier--and in the process, cost you less in the short and long-term.

Asheville: better outcomes, lower costs

One great example of a working Population Health Management strategy comes from the city of Asheville. They identified a problem area in their employees' health: diabetes. The problem was costing them significantly in insurance claims.

Strategists helped them come up with an intervention plan intended to decrease those claims over time. They began offering diabetic employees "community-based pharmaceutical health services," or interventions conducted by specially trained pharmacists and educators from a diabetes education center. These services included meeting with pharmacists for free to set treatment goals, talk about home glucose monitoring and adherence to a treatment plan, and have full physical assessments.

Here's the amazing part: As an incentive to participate, employees also got all copayments having to do with their diabetes drugs and supplies waived. You'd think that move would have increased the city's costs, right?

Wrong. Over five years, the city started saving between $1,200 and $1,872 per patient, per year, because patients started taking their drugs more regularly and needed fewer expensive inpatient and outpatient services. Even better, the intervention worked. More than half of the patients improved significantiy at each visit...