Mercer announced today that employers who offered Mercer Health AdvantageSM (MHA) realized a combined average return on investment (ROI) of $3.30 in health care savings for every $1 spent in 2015. In addition, this program helped improve the quality of care for individuals with chronic conditions, including significant reductions in hospital admissions and readmissions.
MHA is a program offered through select insurance carriers that features high-intensity care management for employees with serious/chronic conditions and acute health needs. On average, Mercer clients find that the sickest 5% of their population represent 44% of the total allowed medical and pharmacy spend – the exact population the Mercer Health Advantage program was designed to assist.
The 3.3:1 average ROI marks a 22% improvement over the 2.70:1 ROI achieved in the prior analysis. Further, Mercer analysis showed the employer ROI results ranged from $1.90 to $4.30 for every $1 invested, yielding an average savings of $430 annually per employee across all programs, a 27% improvement.
MHA directly improved the quality of care for the most “at-risk” population. In a 2015 study comparing MHA to matched non-MHA participants, hospital admissions are 24% lower and the 30 day readmission rate is 22% lower for those with MHA. Employers with MHA also experienced qualified participant engagement as high as 65.2%, and high cost claimant engagement of up to 78%.
The analysis of MHA’s combined results is based on 2015 data from five carriers serving 82 employers and 963,000 members: Aetna, UnitedHealthcare, Anthem, Healthcare Service Corporation (HCSC) and Cigna. Today, MHA currently serves more than 1.39 million employees and their family members across 106 employers. MHA services are coordinated in conjunction with health plans so that the plans’ distinctive capabilities can be leveraged.
“We are very proud of the fact that Mercer Health Advantage’s ROI figures continue to reinforce the value the program provides to our employer clients,” said Mercer’s Jean Moore, Specialty and Innovation Leader for Mercer’s Health Segment. “Even more gratifying, however, is the way Mercer Health Advantage has helped thousands of people get the right care from the right provider and have the support they need from a nurse to help better manage complicated and often chronic medical situations.”
One MHA participant noted that, “My nurse became my lifeline … while my daughter was in the hospital with a serious systemic infection and after she came home. She explained things to me in a way that was easy to understand. I don’t know what I would have done without my nurse.”
While there is some variation in how individual health plans deliver the MHA program, the core MHA model is based on a single nurse from a given health plan working with other specialty clinicians, including physicians, pharmacists, social workers, dieticians and behavioral health specialists to coordinate care for the patient and support the patient’s family. This holistic, high-touch approach encompasses not only much-needed clinical care, but also addresses important and often forgotten issues such as spousal/family involvement, mental/psychological and post-care monitoring. In addition, Mercer provides governance and oversight, giving plan sponsors an in-depth view into the MHA program’s effectiveness.
To learn more about the effectiveness of Mercer Health Advantage, please click here.
*Note to editors – Mercer’s analysis of aggregate claims data and the related savings/clinical improvements do not represent individual health plan or client results. This is one of the several reasons why individual MHA client results will vary. ROI is based on an analysis of claims data and program activity. Various best-practice methods are used to estimate savings from avoided costs attributable to program activity. The Mercer Health Advantage service was available through Aetna, Anthem, HCSC, Cigna and UHC in 2015, and, as such, the ROI result herein is based on their combined performance.
Mercer is a global consulting leader in talent, health, retirement and investments. Mercer helps clients around the world advance the health, wealth and careers of their most vital asset – their people. Mercer’s more than 20,000 employees are based in 43 countries and the firm operates in over 140 countries. Mercer is a wholly owned subsidiary of Marsh & McLennan Companies (NYSE: MMC), a global professional services firm offering clients advice and solutions in the areas of risk, strategy and people. With 60,000 employees worldwide and annual revenue exceeding $13 billion, Marsh & McLennan Companies is also the parent company of Marsh, a leader in insurance broking and risk management; Guy Carpenter, a leader in providing risk and reinsurance intermediary services; and Oliver Wyman, a leader in management consulting. For more information, visit www.mercer.com. Follow Mercer on Twitter @Mercer.