Mercer announced today that employers who offered Mercer Health AdvantageSM (MHA), a proprietary, high-intensity care management program designed to manage care for employees with serious/chronic conditions, realized a combined average return on investment of $2.70 in health care savings for every $1 spent.* Hospital admission rates decreased and health outcomes improved as well.
The analysis of MHA’s combined results comes from four carriers serving 52 employers and 355,000 employees: Aetna, United Healthcare, Anthem and Healthcare Service Corporation (HCSC). A fifth carrier, Cigna, joined MHA in 2015 and therefore is not included in the analysis. Today MHA currently serves more than 1.25 million employees and their family members across 95 employers.
On average, Mercer clients find that the sickest 4% of their population represent 41% of the total allowed medical and pharmacy spend – the exact population the Mercer Health Advantage program was designed to assist.
Further, Mercer analysis showed employers’ saving ranged from $1.70 to $3.10 per employee, averaging $338 annually per employee across all programs. In addition, Mercer’s findings demonstrate that MHA directly improved the quality of care for the most ‘at-risk’ population in the study. Based on 2014 clinical results, hospital admission rates saw a much sharper decrease for the MHA engaged (-18%) versus the non-engaged (-5%) population.
MHA services are coordinated in conjunction with health plans so that the plans’ distinctive capabilities can be leveraged.
“We believe MHA brings personalization back into healthcare,” said Linda Hull, Leader of Mercer Health Advantage. “Finding balance between work and family is challenging, especially when someone is facing a serious illness. Having a ‘nurse in the family’ combined with a support team of specialists meets a true need for our clients and their people. Our member testimonials speak volumes as to how MHA has a positive and meaningful impact on people’s lives.”
Individual health plan programs vary, but the core MHA model is based on a single nurse from a given health plan working with other specialty clinicians, including registered nurses, physicians and behavioral health specialists from the plan to coordinate patient care. This holistic, high-touch approach encompasses not only clinical care, but also addresses such important issues as spousal/family involvement, mental/psychological monitoring and post-care monitoring (see Figure 1). In addition, monitoring and reporting provided by Mercer gives plan sponsors an in-depth view into the program’s effectiveness such as client-specific terms and targets and whether they have been met or immediately addressed.
”When we launched Mercer Health Advantage, we saw a tremendous opportunity to help employers better manage the care of their chronic and seriously ill populations, and to do so in a more cost effective manner,” said Jean Moore, Leader of Mercer’s North American Specialty Practices. “The 2014 analysis demonstrates the true potential of the Mercer Health Advantage solution for employers and employees alike.”
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.
To learn how a large aerospace company utilized Mercer Health Advantage to better control costs and improve patient outcomes, please download the case study at http://www.mercer.us/insights/focus/mercer-health-advantage-case-study.html
*Note to editors- 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 and UHC in 2014, 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.
Figure 1: Mercer Health AdvantageSM improves the quality of care and return on investment of health care spend