Research & News

Magazine Editorial
BABM (Bay Area Business Magazine) Mar/April 2010
By Connie Gee, Vice President of Med-Vision

Dropping Employee Health Coverage? Think again.
View this article online at www.babm.com.

Many CFOs and other decision makers are contemplating the idea of eliminating employee healthcare benefits as a viable cost containment option. The first top-level thought is that you can hardly blame them. Considering healthcare is an escalating cost, dropping plans would represent an annual savings of several million for most companies.

Granted, it is tempting to think that these savings from not paying premiums or self-funded administrative fees, insurance industry fees and Human Resource administration costs could be potentially reallocated to revenue-driven business investments. Although if you do lean towards this choice, are you aware of the consequences?

Consider these corporate soul-searching questions:
1. What will be your return on investment from your greatest asset?
If you fail to invest in employees, it may cost you in terms of innovation, ultimately hurting the long-term value of your brand. Employees may see plan cancellations as “corporate greed” or label it short-term thinking for the sake of shareholder value. Yes, shareholder value is in the forefront, but decision makers cannot underestimate the bottom line impact of motivated employees who build customer loyalty.
2. How will you make up the lost value of the benefit?
If you consider subsidizing employees to buy their own insurance, will you subsidize to the same value of what you have taken away, or will you reduce it by the amount you may have to pay to the government for lack of coverage? If you subsidize to the same value, you have just increased your costs, including additional payroll tax liability for the employee and for the company. You also give up any tax deduction benefit for providing healthcare benefits.
3. Would a subsidy be enough to cover a public option?
If so, for how long? History shows that government programs start out at a low cost the first year but quickly double within a year or two as administrative costs increase. You may also discover that there are more budget items than had been planned or admitted.
4. How will your company’s Workers’ Compensation costs be impacted?
As wages and medical costs go up, so do Workers’ Compensation rates, which have been known to jump almost 200% in a year. The financial implications of an increase in injuries, a rise in legal fees and higher premiums could be detrimental. Even worse, disloyal employees could look to Workers’ Compensation as an opportunity to acquire early retirement through a cash settlement or as a way to be paid two-thirds their regular pay – while on leave. Most employees could also be eligible for additional government entitlement programs and payments. In response, you could increase investments in prevention methods such as workstation and equipment assessments, staff training, education, and monitoring of safety procedures.
5. What effect will this have on unemployment compensation?
Employee morale and productivity of certain workers feeling “shortchanged” is inevitable. After all, the company just reduced its compensation package. Employees may suddenly not be motivated to give the 150 percent they have been asked to give in recent years; in turn, you may be faced with a decision to reduce the workforce and grant undeserving claimants unemployment benefits.
6. Will not having a healthcare benefit impact recruitment?
If your turnover rate increases, you will need to compete to replace outstanding talent. Benefit packages have always greatly influenced a candidate’s decision to accept or decline an employment offer. If your benefit plan has been effectively communicated to potential and existing employees, it most certainly has helped promote a positive image and a distinct competitive advantage in recruiting. Without the healthcare benefit, your competition could have a differential advantage, which would leave you strapped to find an alternative offering, thus, again increasing costs elsewhere.

IMPROVING benefits opposed to reducing…
While mulling over the above questions, think about the quality of your benefit plan. It’s vital for management to monitor efficiencies and accountability of all parties concerned. Whether through training or professional planners, an enhanced understanding of healthcare planning can result in bottom line savings. Employees who are smart healthcare consumers can help you save money. They know about generic drug options and have the sense to use a 24/7 nurse-line instead of an emergency room for their suddenly sick child. They also understand the importance of examining medical bills for accuracy just as they would bills at a restaurant or auto shop.

CONTROLLING your healthcare costs...
When a CFO makes the strategic business decision to play an active role in assessments to manage healthcare costs, the benefits will pay off. There are qualified, medical consulting experts who can help every step of the way, whether in setting up a self-funded program or in improving quality of care through wellness initiatives and risk management. Consistent and reliable assessment of your plan is vital in containing costs. Early identification of solutions to reduce risks and reverse trends can result in cutting healthcare costs, which proves to be a more affordable option than the consequences of dropping benefits altogether.

Med-Vision Announcement

MED-VISION PRESIDENT LAUNCHES HEALTHCARE BLOG

February 2, 2010 (Tampa, Fla.) – The President of Med-Vision, Dan Ross, has launched a blog titled "Insights on Healthcare." Visit Dan's blog to learn more about 20/20 Healthcare Vision.
http://medvision.wordpress.com/

Magazine Article
CFO Magazine: In print February 1, 2010
By Alix Stuart, Senior Editor

What Will Companies Do?
As health-care reform starts and stops, CFOs face difficult decisions about where to invest now.
View this full article at CFO.com

MED-VISION CLIENT, SNYDER'S OF HANOVER, QUOTE:
... Pretzel maker Snyder's of Hanover has kept its health costs flat for five years, thanks in part to efforts to steer employees toward annual physicals, health fairs, and Internet-based second opinions. Even if the company ultimately decides to drop coverage, "it would still be worthwhile to have a wellness program because of the productivity savings," says Penny Opalka, manager of benefits and compensation.

Related On-Line Article
CFO.com: January 13, 2010
By Alix Stuart, Senior Editor

Do Wellness Programs Make Cents?
Employers investing in ways to contain health-care costs, but few know what they're getting back.
View this full article at CFO.com

MED-VISION CLIENT, SNYDER'S OF HANOVER, QUOTE:
... Snyder's of Hanover, for example, managed to keep health costs per employee month flat for five years between 2003 and 2008, in part due to sophisticated data analyses and efforts to steer employees toward annual physicals and top experts in any given field. Last year, however, several health-screening fairs at the Pennsylvania-based pretzel-maker's various manufacturing facilities turned up employees with serious illnesses, saving at least one employee's life, according to Penny Opalka, manager of benefits and compensation.

Announcement
For additional information, contact:
Connie Gee, Vice President: 813-205-1577
connie.gee@med-vision.com

FEBRUARY IS NATIONAL HEART HEALTH MONTH
Connie Gee offers interactive heart health seminar for employee wellness
January 23, 2010 (Tampa, Fla.) – Med-Vision, a Tampa-based medical consulting company providing strategies to lower healthcare costs and improve quality of care, announces that Connie Gee, a worksite wellness and health claims data analyst, will be presenting an interactive and educational Heart Health & Blood Pressure seminar at H. Lee Moffitt Cancer Center & Research Institute on February 18.

In celebration of "National Heart Health Month," Gee’s Heart Health & Blood Pressure seminar is being made available to other organizations, healthcare facilities, and corporations throughout the month of February. Contact Connie Gee for more information about booking her to present to your employees or to speak at your next event: 813-205-1577 or email connie.gee@med-vision.com.

Founded in 2005, Med-Vision delivers healthcare planning, risk management, and wellness consulting to help employer groups achieve optimal employee health and productivity. Med-Vision specifically caters to the needs of self-funded employer plan sponsors and currently impacts more than 75,000 health plan members across the U.S. Med-Vision has helped corporations, healthcare facilities, municipalities, and school districts to reduce risks, reverse trends, and decrease healthcare costs while increasing quality of care.

Verisk Health, Inc. Press Release
For Immediate Release
For additional information, contact:
Trish Tarantino: 781-693-3784

MED-VISION TEAMS WITH VERISK HEALTH TO REDUCE HEALTHCARE COSTS
AND IMPROVE EMPLOYEE WELLNESS
Innovative strategies fueled by data analytics help
reduce healthcare costs by 10 to 12 percent.
Click here to view, share, or print this release.

January 11, 2010 (Waltham, Mass.) – -Verisk Health, Inc. today announced that Med-Vision, LLC helped clients reduce healthcare costs by 10 to 12 percent with Verisk Health’s Explorer solution. Verisk Health is a global leader in identifying, analyzing, and predicting healthcare risk. Med-Vision is a leading medical consulting company.

“Data is power in healthcare and the starting point for enabling meaningful change,” said Dan Ross, chief executive officer and founder of Med-Vision. “Verisk Health gave us the tools we needed to unlock the data and identify the cost drivers and trends to significantly reduce spending for our employer groups.”

Med-Vision implemented Explorer several years ago as a creative solution to the complex healthcare crisis facing its mid-to-large sized employer clients. The company’s goal was to shape new quality care approaches by drawing on data analytics to understand employer cost trends, identify drivers, and determine how best to lower healthcare expenditures. Explorer, a web-based data analytics solution, helped Med-Vision identify and execute strategies to successfully lower costs while improving clinical, financial, quality, and utilization metrics.

“Across the board, most employer groups lack visibility into what is truly driving healthcare outcomes and costs,” said Nathan Gunn, chief medical officer at Verisk Health. “Med-Vision’s success with our Explorer product is positive proof that clear insight into data goes a long way toward impacting the bottom line.”

Working with clients, including a cancer treatment center and a regional school district, Med-Vision analyzed existing data and developed strategic programs that addressed the specific trend, quality, and compliance issues of each population. Med-Vision’s programs improved clinical and financial metrics for many of its clients. In one instance, Med-Vision lowered healthcare costs by 10 to 12 percent over two years. The company’s efforts also helped educate members on chronic disease management and prevention, which encouraged healthier lifestyle behaviors. Other results from Med-Vision’s campaigns include:

• emergency room visits decreased by 11.9 percent
• per member per month pharmacy costs decreased by 19.3 percent
• per member per month cost decreased by 8.6 percent
• inpatient days declined significantly
• breast cancer screening compliance improved by 38 percent
• generic drug use increased by 4 percent

To learn more about Med-Vision’s success using Explorer, read the case study: Verisk Health Empowers Med-Vision to Lower Its Client's Healthcare Costs.

About Verisk Health:
Verisk Health, a subsidiary of Verisk Analytics, leverages healthcare data to help organizations and governments understand their medical and financial risk for the purpose of managing costs and clinical outcomes more effectively. Through the combination of leading predictive science, the finest evidence-based clinical engine, and superior technology, we have created the most extensive independent risk-assessment and decision-analytics platform in the healthcare industry. Our primary focus is to identify actionable strategies for managing healthcare costs and quality at both the individual and population levels. We consistently research, evaluate, and invest in our business to ensure that we remain leaders in our industry and the most efficient and effective solution for our clients. For more information, please visit http://www.veriskhealth.com.

About Med-Vision:
Founded in 2005, Med-Vision delivers healthcare planning, risk management, and wellness consulting to help employer groups achieve optimal employee health and productivity. Med- Vision specifically caters to the needs of self-funded employer plan sponsors and currently impacts more than 75,000 health plan members across the U.S. Med-Vision has helped corporations, healthcare facilities, municipalities, and school districts to reduce risks, reverse trends, and decrease healthcare costs while increasing quality of care.

News Article
The St. Petersburg Times: In print Dec. 14, 2009
By Irene Maher, Times Staff Writer

Corporate checkup can yield healthcare savings
View this article online at www.tampabay.com.
TAMPA — If any employer would know how to manage its own workers' health care expenses, you might think it would be a hospital.

But at a time when costs are soaring so high that many employers are cutting or even eliminating coverage, even health experts need help.

That's the case at Moffitt Cancer Center, which three years ago hired Tampa consulting firm MedVision to look at how its 3,100 employees were using their health benefits.

Today, the most visible result of that analysis is a new clinic where workers can get basic care. MedVision discovered that many employees were putting off going to the doctor because they didn't want to take so much time away from work. As a result, simple ailments sometimes became costlier problems.

The clinic "is here, it's free, it's accessible. The easier we can make it for employees to access primary care, the better," says Michele Talka, director of compensation benefits at Moffitt.

Talka said that and other changes recommended by MedVision have controlled costs enough that Moffitt could limit employee premium increases this year. That despite the fact that it has hired some older workers with pricier health issues.

Last week, MedVision invited local employers to the Tampa Club downtown to hear about its services, and 43 people sat in rapt attention.

Among them were Margaret McGarrity of the Sarasota County Sheriff's Office, which is considering breaking away from the county health plan and putting its 976 employees in a self-insured group.

"We're just in the exploration phase, but we're looking at all our options," McGarrity said.

Little wonder. At a time when politicians are struggling with health reform and clearly nervous about Medicare cuts, employers are having to find their own ways to contain costs. And their workers can testify that for all the political uproar, managed care already is a fact of life.

The cost of employer-sponsored health care is up 5 percent this year, according to the Kaiser Family Foundation. Workers paid an average of just over $3,500 for family coverage this year, while employers contributed more than $9,800 per worker. At this rate, the cost to employers will rise to more than $28,000 per worker in a decade, according to the Business Roundtable.

Enter the health care consultant industry, which promises savings — or at least better controlled increases — by analyzing spending patterns.

At the Tampa Club presentation, Biologics, which specializes in the cost of cancer care, said it saved one client $19,000 when it discovered a patient was billed for a higher dose of medication than she actually received. In another case, switching a colon cancer patient from a brand-name drug to a similar generic drug netted a savings of more than $15,000.

MedVision works exclusively with self-funded employer groups such as Moffitt, Manatee County schools and Sarasota County government. MedVision president Dan Ross, who started the company in 2005, has more than 20 years in the employee health industry, 17 of them spent at Cigna.

The single biggest way to control costs, he said, is spending more on wellness.

"Our goal is to prevent people from getting sick and to keep people from getting worse," he said.

In Florida, he said, the biggest costs MedVision sees surround cancer care.

"In (employee) groups where a lot of women are over age 40, breast cancer is costly," he said. "We look at what percentage of women are getting mammograms and we can almost always improve those numbers" of women getting regular screenings to catch tumors early.

Research shows that many patients with chronic illnesses such as diabetes, high blood pressure and arthritis often don't take their medication as prescribed. They may stop it if they start to feel better or the side effects become intolerable. That can lead to serious, even life-threatening complications.

So MedVision might recommend bringing in nurses to coach those patients on the need to stick with their treatment. In other cases, data analysis might reveal high use of expensive brand-name drugs for which there are generic substitutes.

Moffitt, for instance, no longer pays for pricey acid reflux reliever Nexium, only covering the generic version. Other than insisting on generics, Moffitt has not eliminated treatments from its coverage, she said.

Talka notes that using MedVision's services enables Moffitt to make these changes while preserving patient confidentiality.

"We don't care who has diabetes. We just want to know how many cases we have," she said.

"If someone hasn't filled their blood pressure prescription in six months," Talka said, "then disease management nurses will reach out to them to discuss what's going on."

But reaching out is all they can do. Employee participation is strictly voluntary, she said.

"We can't make people get medical care."
View this article online at the St. Petersburg Times' site
Published December 14th 2009

Press Release
For Immediate Release For additional information, contact:
Connie Gee, Vice President: 813-205-1577
connie.gee@med-vision.com

MED-VISION AND BIOLOGICS CO-HOST A CANCER MANAGEMENT WORKSHOP
Event to offer employer strategies for lowering costs and improving quality of care
Click here to view, share, or print this release.

November 19, 2009 (Tampa, FL) – The healthcare planning team of Med-Vision has partnered with the premier cancer management company, Biologics, Inc., to present a Cancer Management Workshop on Dec. 8 from 8 a.m. to 1 p.m. at the Tampa Club, 101 Kennedy Blvd., Suite 4200, Tampa. Continental breakfast and lunch are included in this free event focused on comprehensive cancer management strategies for employers and payors. To register, e-mail connie.gee@med-vision.com by Dec. 1.

“Cancer absorbs 15 to 25 percent or more of an employer’s annual healthcare budget,” said Connie Gee, vice president of Med-Vision. “This informative workshop will unveil proven strategies for lowering cancer costs while achieving high rates of member and provider satisfaction.”

Robin U. Smith, Biologics, Inc. chairman and chief executive officer, will lead the workshop in an effort to provide a patient-focused platform for managing the financial, emotional, and physical challenges of cancer. A recognized trailblazer in oncology healthcare, Smith leads Biologics, Inc. with over 25 years of experience in designing and developing successful cancer management strategies. A portion of the workshop will focus on Biologics’ newest cancer management strategy named OncoSentrics, which uniquely enables self-funded employers and health payors to elevate cancer care for members while lowering healthcare costs.

About Biologics, Inc.: Founded in 1994 and based in Cary, N.C., Biologics, Inc. is a cancer management company with an innovative business model that brings together the many complex components of cancer care. Biologics is at the center of the rapidly changing oncology environment to support treatment modalities, clinical outcomes, and informatics and to leverage established relationships with oncology clinicians, patients, payors, researchers, and manufacturers. The company operates four divisions: Oncology Pharmacy, Oncology Clinical Trial Services, Oncology Management Services for payors, and Oncology Biopharmaceutical Solutions for manufacturers.

About Med-Vision, LLC: Founded in 2005 and based in Tampa, Fla., Med-Vision delivers medical consulting, healthcare planning, risk management, and wellness consulting to help employer groups achieve optimal employee health and productivity. Med-Vision specifically caters to the needs of self-funded employer plan sponsors and currently impacts more than 75,000 health plan members. Med-Vision has helped corporations, healthcare facilities, municipalities, and school districts to reduce risks, reverse trends, and decrease healthcare costs while increasing quality of care.

Press Release
For Immediate Release For additional information, contact:
Connie Gee, Vice President: 813-205-1577
connie.gee@med-vision.com

NATIONALLY RECOGNIZED HEALTHCARE EXPERT JOINS MED-VISION TEAM
Med-Vision's healthcare analytics division expands to include Jeffrey A. Gasser
Click here to view, share, or print this release.

November 3rd 2009 (Tampa, FL) – Med-Vision, a Tampa-based medical consulting company, announces that Jeffrey A. Gasser, president of Gasser Consulting, has joined the Med-Vision team as a principal and equity owner. Along with the recent addition of Connie Gee as vice president, Gasser’s appointment will enhance Med-Vision’s efforts to provide strategic healthcare cost solutions for self-funded employer groups across the United States.

“We are thrilled our clients will have access to vast expertise across the entire healthcare continuum,” said Dan Ross, president of Med-Vision. “Jeff’s keen knowledge of healthcare analytics, coupled with his expertise in the healthcare provider’s world, brings nationally unique value to Med-Vision’s client concerns of healthcare cost and quality.”

A graduate of the University of Tampa, Gasser began his career as a certified public accountant working primarily with healthcare clients. Gasser proceeded to build over 30 years of diversified experience in all facets of healthcare and health benefits. As a healthcare analytics expert, he has been a co-founder of several companies in the healthcare industry and has served as a senior advisor to many others. His meticulous analysis of healthcare claims information has resulted in millions of dollars in employer savings.

With involvement in businesses ranging from home healthcare, to pediatric alternate site services to dialysis, Gasser recently co-founded D2Hawkeye, Inc., a healthcare analytics firm based in Waltham, Mass. He currently serves as a strategic advisor to the Oncology Management Services division of Biologics, Inc., which is based in Raleigh, N.C. Gasser also serves as a senior managed care advisor to PivotHealth, LLC, a physician consulting business in Brentwood, Tenn., and he is a senior advisor to Medicare Advantage Review Associates in Boston, Mass.

“Med-Vision’s services, anchored by data, are defining new paradigms with respect to employer plan cost, quality outcomes and identifiable ROI,” said Gasser, who can be reached via email at jeff.gasser@med-vision.com. “I’m excited to become a team member and advisor.”

Founded in 2005, Med-Vision delivers healthcare planning, risk management, and wellness consulting to help employer groups achieve optimal employee health and productivity. Med-Vision specifically caters to the needs of self-funded employer plan sponsors and currently impacts more than 75,000 health plan members. Med-Vision has helped corporations, healthcare facilities, municipalities, and school districts to reduce risks, reverse trends, and decrease healthcare costs while increasing quality of care.

Press Release
For Immediate Release For additional information, contact:
Connie Gee, Vice President: 813-205-1577
connie.gee@med-vision.com

MED-VISION REDEFINES TAX ON ‘GOLD-PLATED, CADILLAC’ HEALTH PLANS
Expert Analysis of Tax Concept for Healthcare Reform
Click here to view, share, or print this release.

October 8, 2009 (Tampa, FL) – Dan Ross, founder and president of Med-Vision, a Tampabased medical consulting company, asserts that the Senate Finance Committee’s proposal to impose a 40 percent tax on individuals in “gold-plated, Cadillac” health insurance plans would be best described as a tax on groups of the chronically ill. With these “high-dollar” plans priced at $8000 or more for individuals and $21,000 or more for families annually, the proposed tax and other taxes on insurance companies are the latest attempt to raise $774 billion over 10 years to fund healthcare reform.

“Some in Washington believe ‘Cadillac’ plans have lower deductibles and co-payments, but high-dollar plans relate more to misery and sickness from chronic disease,” said Ross, who warns that the perception of taxing “the guy covered by the rich health plan” will backlash into a “circular firing squad.”

By targeting individuals in groups covering the highest number of sick, the tax will disproportionately affect those in plans offering retiree coverage, populations with older average ages, and residents of states with higher healthcare costs. Plans with lower deductibles and co-payments are producing lower aggregate cost, as evidenced by a national move to medical homes and employer-sponsored on-site health clinics, which have lower deductibles and co-payments.

Ross, who has 20 years experience in the employee benefits industry, conducted an analysis of 200,000 plan members covered under multiple employer self-funded health plans. The two-year analysis looked at claims totaling $800 million.
Among the findings:

• 85% of the group (170,000 members) accounted for $155 million or 19% of annual claims. This larger percentage averaged $456 per member.
• 15% of the group (30,000 members) accounted for the remaining $645 million or 81% of
  annual claims. This smaller percentage averaged $10,800 per member.

Med-Vision also points to the Centers for Disease Control and Prevention, which estimate that chronic disease accounts for 75 percent or $1.5 trillion of our national $2 trillion annual healthcare spending. Similarly, the Robert Wood Johnson Foundation published that caring for those with chronic disease accounts for 78 percent of all health spending.

Founded in 2005, Med-Vision delivers healthcare planning, risk management, and wellness consulting to help employer groups achieve optimal employee health and productivity. Med- Vision specifically caters to the needs of self-funded employer plan sponsors and currently impacts more than 75,000 health plan members across the U.S. Med-Vision has helped corporations, healthcare facilities, municipalities, and school districts to reduce risks, reverse trends, and decrease healthcare costs while increasing quality of care.

Press Release
For Immediate Release For additional information, contact:
Connie Gee, Vice President: 813-205-1577
connie.gee@med-vision.com

Med-Vision Expands efforts to Shrink employer Healthcare Costs
Vice presidential appointment and new website designed to promote wellness.
Click here to view, share, or print this release.

October 01, 2009 (Tampa, FL) – Med-Vision, a Tampa-based medical consulting company providing strategies to lower healthcare costs and improve quality of care, announces that Connie Gee, a worksite wellness and health claims data analyst, has taken the helm as vice president.

Gee’s appointment in conjunction with a more client-centric website helps to expand Med-Vision’s scope of services to combat rising healthcare costs. The Med-Vision model applies data gathering and analytics to understand and manage healthcare trends. Through predictive risk modeling, quality compliance, and corresponding wellness strategies, Med-Vision meets the twin goals of improving employee health and lowering healthcare costs.

“Med-Vision’s differentiator is that we provide site-specific solutions that encourage truly meaningful lifestyle changes,” said Gee, who has two decades of accomplishments in health promotions, disease management, workforce utilization, and wellness programming. “I am thrilled to be creating customized programs distinctively based on client information and factual analytics.”

In addition to an MBA from the University of Tampa, Gee holds a certificate in Human Resource Management and has held various accreditations from health and fitness organizations. Gee’s past experience includes 10 years in the development of health promotion programs for Tampa General Hospital, which positions her to address the critical healthcare-related issues that plague midsize-to-large employers. Her primary functions at Med-Vision include reviewing critical plan data, identifying cost drivers, and determining actions for reducing healthcare costs. Verisk Health’s D2Explorer tools help Gee and other experts to aggregate and analyze patient information that is typically inaccessible to employers. Gee weaves together that data and collaborates with clients, insurance carriers, TPAs, and HR benefits staff to provide creativity in implementing healthcare initiatives, disease management programs, and wellness plans.

“I’m pleased that Connie Gee has chosen to join Med-Vision to apply her vast healthcare experience and passion for excellence,” said Dan Ross, Med-Vision’s founder and president with more than 20 years experience in the employee benefits industry. “She is uniquely skilled in interpreting employer-specific data to create integrated wellness strategies to boost our client’s financial and productivity results.”  

Founded in 2005, Med-Vision delivers healthcare planning, risk management, and wellness consulting to help employer groups achieve optimal employee health and productivity. Med-Vision specifically caters to the needs of self-funded employer plan sponsors and currently impacts more than 75,000 health plan members across the U.S. Med-Vision has helped corporations, healthcare facilities, municipalities, and school districts to reduce risks, reverse trends, and decrease healthcare costs while increasing quality of care.

Case 1: Food Manufacturer
Company was concerned about the uncharacteristic 15% healthcare cost increase. The company immediately took action to improve performance but yielded a 5% reduction after two years. Believing that improving employee healthcare quality would further reduce costs, Med-Vision was hired to analyze cost drivers and recommend additional actions.
Med-Vision analyzed the employer’s data and identified ER visits and certain chronic diseases as top cost drivers. Med-Vision’s plan included wellness initiatives that provided education and awareness of disease management strategies and the importance of treatment compliance.
Med-Vision’s program addressed acute and chronic care trends and care management options. Diabetic counseling and one-on-one clinical consultations were established to review treatment plans, encourage lifestyle decisions to improve quality of life, coordinate services, and maximize benefits.

Results:
Success of the plan led the employer to open an on-site health clinic
PMPM pharmacy costs decreased 19.3%
Overall PMPM decrease
Inpatient days decreased
Generic drug use increased
ER visits decreased
Absenteeism decreased

Case 2: Regional School District
An 8,000 employee school district experienced rising medical spending trend. Med-Vision’s data analytics capabilities discovered chronic and co-morbid conditions, and preventive care non-compliance.
Med-Vision then designed value-based benefits and employee worksite wellness strategies to reduce the trend and the healthcare costs. Wellness visit copayments were eliminated to encourage preventive care and behavior change. It was determined that covering the cost of supplies for certain chronic conditions saved money. A wellness committee was established to communicate the value of healthy lifestyle choices and to deliver the wellness initiatives. Employees were rewarded for participating in education programs with lower copayments and subsidized supplies.

Results:
Healthcare costs decreased 10 to 12% in two years.

Case 3: County Government
Healthcare costs were rising but the cost drivers and solutions were unknown. Med-Vision’s data analytics discovered that 3.8% of the employee population was diagnosed with cancer and that it was only one of the top five diagnoses driving costs. Inconsistency in treatment unit costs indicated huge variances in practice patterns. Utilization metrics also indicated that employees with cancer were ten times more likely to visit the Emergency Room, and not comply with recommended cancer prevention screenings.
Med-Vision partnered with Biologics, a cancer management service provider, and a diagnosis and treatment service to establish a new care management approach. Pharmacological treatments were compared to national treatment practice guidelines to ensure correct therapy was used.
Med-Vision’s identification of unit cost of member care, and medical and pharmaceutical cost and quality trends data, identified costs and compliance improvement areas.

Results:
The county experienced an 8.6% PMPM cost decrease and a 38% improvement in breast cancer screening compliance. Because employees received the right care at the right time, care quality improved and costs declined.

Case 4: Cancer Treatment Center
A nationally recognized cancer treatment center earned the CEO Cancer Gold Standard™ certification awarded to organizations meeting high standards for cancer prevention, screening, and care for employees and family members.
Med-Vision supported the cancer treatment center’s commitment by developing an integrated benefit design approach to promote wellness initiatives, preventive screenings, and on-site clinics.
Med-Vision’s data analytics explored the impact a wellness management program would have on costs and quality of care. Higher costs were driven by inpatient admission, ER visits, and co-morbid conditions. The costs associated with depression were also determined.

Results:
Implementing a wellness management program increased the cancer treatment center’s preventive care compliance, provided education on depression screening, and reduced overall employee population risk. The cancer treatment center reported zero trend over two years, avoiding the previous trend of an average 12% annual increase.