Shortlister hosted Lee Murphy, CEO/Founder at Inspera Health, to learn how to transform the health of individuals with five or more lifelong multiple chronic conditions. (MCCs)
FACT: Employers continue to focus on high cost claimants as a top priority.
50% of your members between the ages of 45 & 64 have MCCs.
12% have 5+ MCCs representing 40+% of your health care spend.
20% of members account for 80+% of your health care spend.
Most health improvement solutions were created to address single, specific conditions. When there are multiple chronic conditions, managing those conditions becomes very complex. Furthermore, most conditions, once present, typically require lifelong management for sustained change and this requires lifestyle improvement.
Inspera Health is a health improvement company with over 20 years of laser-focused experience targeting high cost claimants with multiple chronic conditions (MCCs). Their validated metrics for measuring investment and health outcomes are part of a comprehensive large claim reduction strategy.
MCC POPULATION ATTRIBUTES
Have 50% longer tenure than average (not career mobile)
75% have behavioral health conditions, which amplify other conditions
Are not identified as a strategic target focus
Have higher risk and 10x to 30x higher cost over a multi-year period
EFFECTIVE MANAGEMENT ATTRIBUTES
Because of the complexities associated with having 5+ MCCs, short-term, digital solutions will NOT produce sustainable outcomes. According to the AHRQ (a division of HHS) MCC Research Network findings, effective management attributes consider the following:
• People with MCCs are more than just a collection of diseases
• Patient preferences and values need to be assimilated
• Consideration of the person in context of their relationships
• Inclusion of mental health care as an integral part of health
INSPERA HEALTH PROGRAM OVERVIEW
1. Recruitment and Enrollment – varied length
2. Assessment and Plan Development – 0-80 days
3. Core Program – 12-18 months
4. Graduation Preparation – 2-4 months
1:1 HEALTH IMPROVEMENT SUPPORT and program services included are:
• Intake, including comprehensive clinical behavioral health assessment
• Ongoing health improvement coaching
• Behavioral health counseling
• Biometric screening
• Nutrition counseling
• Fitness membership / Personal trainer
• Financial counseling
• Massage therapy
• Licensed, independent external resources for assessment and impact measurement (mental health, physical health, health activation, biometrics, participant satisfaction)
• 55 – 125 hours of one-on-one support for each participant PLUS facilitated group education and health transformation sessions
RESULTS AND SUSTAINABILITY
In a 5-year Client Case Study, the impact of Inspera Health resulted in over 85% of participants reporting improved health.
Weight Loss: 71% lost an average of 4%
Physical Activity: 90% had an average increase of 600%
38% overall improved health based on 10 separate clinical and behavioral measures
ROI: 2.5x return on investment
NO-COST DATA STUDY OFFER
Your customized report will identify opportunities for impact in your MCC population, such as:
• Identify members with multiple lifelong chronic conditions showing cost per # of conditions
• Impact by age and tenure
• Additional condition acquisition rate AND future cost estimate for those with 3, 4, 5+ MCC
• Identification of Inspera Health eligible invitation cohort
• You can then review this invitation cohort to see: historical costs, historical health improvement engagement, average age/tenure – to assess if any current options are effective with this group
• Cost and liability projection for the expected engaged portion of cohort
• Inspera Health’s value proposition, health improvement results and guarantees
INSPERA HEALTH’S GUARANTEE
Inspera Health guarantees that their program will achieve a 30% improvement in the graduating population. If improvement targets are not met, the program costs are commensurately reduced. With that guarantee option, there is a pay-for-performance incentive that can be earned for meeting specific targets. Inspera Health also offers a full fee at risk and shared savings financial guarantee. 30% cost reduction on program graduates is guaranteed, or all fees are commensurately refunded. With this guarantee, if a 30% cost reduction is achieved, all additional savings are split between the client and Inspera Health (shared savings).
With a 10% invitation engagement rate you should see a 1% reduction in your future total plan spend, Inspera Health guarantees not only ROI, but a healthier employee population as well.