Care Navigation Cost Savings Study

Background.

The importance of measuring Rightway’s impact on healthcare spending has been apparent since day one. For years, we’ve been using an evidence-based methodology to estimate the cost savings we deliver for our clients. However, we thought it would best to complement our internal navigation cost savings estimates with external validation by a third-party vendor.

To perform such an analysis, we chose to partner with Aon, a global firm respected in the industry for their data and analytics capabilities. Aon is held in high regard for its rigorous cost savings analysis methodologies. Aon’s methodology uses an ‘apples-to-apples’ study approach by comparing Rightway members to non-Rightway members with similar demographics and clinical profiles.

Study design.

Measuring cost savings in healthcare is a challenging exercise. While the most common method of measuring navigation cost savings is to compare year-over-year healthcare costs, the results of these studies often reflect only population changes or random variation and not actual changes in healthcare spending.

Aon’s methodology used a simple but rigorous case-control study design. In the study, the healthcare costs of members using Rightway’s solution were compared to those of similar healthcare consumers not using Rightway’s solution. Information on these individuals was gathered from a national database with 15 million commercially-insured claimants. The following steps were used:

1. Patient demographic matching:
Each Rightway member is matched to three controls with identical demographics (by age, gender, and geographic region).

2. Patient clinical characteristics matching:
Each Rightway member is matched to three controls with identical clinical profiles, more than 25 chronic conditions are used in the patient matching algorithm.

3. Removal of outliers:
Aon removed individuals with more than $350,000 in annual healthcare spending to reduce variation in the data.

4. Comparison of healthcare costs:
After Rightway members are matched to identical controls and outliers are removed, the healthcare costs of the two groups are compared. This is represented in the central findings of the study.

Study findings.

Aon’s study focused on the healthcare spending of three Rightway clients, all of whom implemented Rightway's care navigation platform for their employees in 2018. The results of the case-control study provided strong evidence that Rightway members have lower healthcare costs compared to market averages.

Among Rightway members, healthcare costs averaged $4,643 per-member per-year (PMPY) compared to $5,466 PMPY for matched controls - a reduction of $823 PMPY or 15% lower healthcare costs.

In addition to these findings, the study also generated insights about which specific segments of member populations Rightway has an outsized impact on. Most notably, decreased spending among persons with chronic conditions was observed by Rightway clients; healthcare costs among persons with one and two or more chronic conditions were 26% and 12% lower than their matched controls, respectively. The table below presents these highlights:

Closing.

In conclusion, a rigorous actuarial analysis performed by the respected analytics firm Aon demonstrated that Rightway employers have significantly lower healthcare costs compared to the market. The value of our high-tech, high-touch approach to care navigation has never been more clear and we’ll continue using meaningful data to measure our impact.