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Being a benefits leader is a tough job. There’s just one of you for thousands of employees. You have to balance cost containment with great programs that attract and retain employees. There are never enough hours in the day. It’s no picnic.
But there are those strategic wins that make it all worthwhile. Those moments when you found a way to make the lives of employees better, and it didn’t cost you anything. Or when you found a cost-cutting measure that you can implement seamlessly without disrupting your members. It could even be as simple as finding a window into your members’ health that you couldn’t see before.
We want to highlight some of these moments from our customers.
Artemis’ proprietary data models capture hidden insights in benefits data. With the help of clinical experts and skilled analysts, we identify quick wins for our clients. In this case, we used our “Inefficient Rx” app to find out if a generic drug substitution would help curb costs.
Fortamet is a commonly prescribed name-brand drug for Type II diabetes. It’s an extended-release tablet that contains an oral antihyperglycemic drug, and it’s very effective for managing this condition. However, members taking Fortamet do have another option. With help from our clinical staff, this client identified a drug substitution that’s the exact same molecular composition as Fortamet: metformin.
The de-identified data we used in this analysis showed a few key findings:
This win not only helped control Rx costs for our customer, but also for their members with Type II diabetes.
An Artemis customer wanted to know if members who participated in their fitness-oriented wellness program had lower healthcare costs. This is a bit of a “white whale” for employers—they all offer fitness and wellness programs, and they’d all like to know the results and outcomes of those initiatives.
But it’s not easy. Many employers find, like our customer did, that people who were participating in the wellness program actually incurred higher healthcare costs that those who were not participating at all. The assumption is that those who sign up for fitness challenges and wellness programs are more concerned about their health. Maybe they’re wanting to change unhealthy habits or lose weight, and these factors are thought to explain why those who participate are still incurring higher costs.
So how do we control for this result and find out what’s happening? Using a multivariate regression analysis, you can control for variables like age, risk scores, and gender, which state the individual lived in, what year the observation of data came in, and even unobservable individual characteristics. In this analysis, we found that after controlling for these things, there were not statistically significant higher costs.
But what if we looked at the most active, enthusiastic participants? We sliced the data to look at higher level participation (more steps, more points earned) and compared it to lower level participation.
We found that for every additional health point earned, it saves the employer 3 cents in healthcare costs. For every 10,000 steps a participant takes, it cost the employer $6 less in PMPY. The relatively enthusiastic point earners —the 75th percentile—incur $50/month fewer costs than their counterparts who are still participating but are average (median) point earners.
Wellness program performance is tough to measure, and together with Artemis, this customer found the data to justify the expense.
Our third success story revolves around musculoskeletal conditions. This Artemis customer wanted to explore the treatment of common musculoskeletal conditions with physical therapy vs. opioids.
The CDC guidelines clear favor physical therapy over opioids for treating chronic pain. “There is high-quality evidence that exercise therapy (a prominent modality in physical therapy) for hip (100) or knee (99) osteoarthritis reduces pain and improves function immediately after treatment, and that the improvements are sustained for at least 2-6 months.”
With this recommendation in mind, we set out to find out if members were choosing physical therapy over opioids for their musculoskeletal conditions. We dove deep into member utilization on two conditions: low back pain and osteoarthritis.
For low back pain, you can see that 58% of members with this condition were prescribed opioids, compared to just 29% who were treated with physical therapy. The trend holds for arthritis.
Just 9% of this population used PT for pain relief, while 61% were prescribed opioids. For long-term, chronic conditions like these, extended opioid use can lead to tolerance and addiction.
Armed with this data, the customer is considering a few plan changes:
These wins are just a few examples of how Artemis customers are making a difference with their benefits data.