LMR Case Study Employee Population

1. Target Population Description
   • Employees of a regional medical center.
2. Objective/Goals
   • Modify lifestyle related conditions that are responsible for 30 percent of the company's medical costs.
   • Reverse upward trend in health care spending.
3. Linkages to Follow-up Programs
   • Telephonic health line for counseling on fitness, nutrition and preventive health issues and receiving general health, medical self-care information and wellness newsletters.
   • Physician referral for high-risk individuals.
   • Case management for smokers and overweight(20%) and underweight(20%) individuals.
4. Results/Measures
   • The program was implemented at the beginning of a benefits cycle.
     • 23,621 employees were covered by the company's health plan, 84 percent elected to participate in the program. (The majority of participants did not fall into a high-risk category or require referral to a physician, however everyone gained access to the interventions, education and support for healthy lifestyles)
   • After the assessment
     • 3.4 percent were identified with conditions requiring a referral to a physician.
     • 13.2 percent were identified with high-risk factors that had been associated with lifestyle-related illnesses.
   • After six months
     • 12.6 percent of the case managed group had met their goals by the end of year one.
   • By the end of year
     • 36.3 percent had met their goals for a total of 50 percent.
   • Financial Impact
     • Lifestyle related claims dropped that year by $1.1 million.
     • Medical claims overall fell 9 percent, saving the company $5million.
     • Cost per employee trended downward, dropping 5 percent.
     • Inpatient utilization decreased 21 percent per 1,000 lives.

   These reductions occurred in spite of additional benefits of nearly $9 million that were added to the employees health plan (i.e. prenatal, EAP, well baby care etc.) The following year's anticipated budget of $75 million was cut by $23 million to levels well below the previous years spending.

   The annual cost for the program was $1.5 million. However, the employer actually recovered their entire $1.5 million investment in the program through contributions from non-participants. The additional $34 a month in health premiums paid by the 16 percent (3,773 employees) who elected not to participate in the program added $1,539,384 to the company's health benefits program. Through the contribution of the 16 percent the program's costs were fully recovered.

5. Discussion
   The results of this study seemed to suggest that a well-planned program focused on better health risk management practices can make a systematic contribution to better health practices for the program participants. The results showed a Return on Investment (ROI) of over 400 percent based on a program cost of $1.5 million dollars and claim reductions of $6.1 million dollars.