School District Breaks the Rising Health Costs Trend

Combatting the nationally rising health costs while improving the health of employees is no easy feat, but the self-funded Manatee County School District synchronized a team of consultants to keep its per member per month costs flat over the past three years, offsetting the national trend of 10 percent yearly cost increases. 

It all started with the district’s forward-thinking risk and benefits department assembling a team of subject-expert consultants to help the district improve member health and lower costs.  Med-Vision, LLC, First Florida Insurance Brokers, and Siver Consultants are among the expert consultants that worked with the district’s management and wellness teams as well as the district’s plan administrator, Blue Cross Blue Shield of Florida, in implementing and managing its strategic wellness program titled “HealthVantage.”

HealthVantage includes an array of preventative screenings, wellness consultations, on-site flu shots, fitness challenges, tobacco cessation programs, and disease management programs customized for the district’s nearly 5,000 employees.  Not one component of HealthVantage was chosen at random.  Verisk Health’s Sightlines Medical Intelligence data analytics was utilized to help the district’s wellness team analyze conditions and direct them in creating site-specific solutions.

“The work Med-Vision has done with Manatee County School District is a great example of how identifying risk in an actionable way is crucial to ultimately mitigating that same risk,” said Nathan Gunn, MD, chief operating officer of Verisk Health.  “Med-Vision was able to use our predictive modeling and data analytic solution to help the district understand and manage its healthcare risk while also setting up interventions for mitigating that risk.”

Dr. Gunn goes on to say, “The 13 percent reduction in member care-gap index between 2009 and 2010 is a clear indication of increased quality of care and better treatment compliance.  The benefit modifications and alignment to high-performing networks that have resulted has allowed the district to reach an ideal scenario – the ability to maintain essentially a flat healthcare trend during the past three years.”

Back in 2008, data analytic capabilities discovered chronic and co-morbid conditions as well as preventive care non-compliance.  Approximately 5 percent of members with serious conditions were accounting for nearly 51 percent of the districts total healthcare costs.  Aggregate claims, trends, and diagnostic groups helped the district mitigate costs by:

• Designing wellness and disease management programs to meet employee needs and fit their schedules. 
• Establishing a wellness committee to communicate the value of healthy lifestyle choices. 
• Eliminating wellness visit copayments to encourage preventive care and behavior change. 
• Subsidizing supplies for certain chronic conditions. 
• Rewarding employees for participating in education programs with lower copayments.

In 2010, Med-Vision, LLC also helped the district negotiate lower drug pricing with its pharmacy benefit management company.  Despite a general increase in prescription fills, the district lowered prescription drug claims cost by $500,000.  Additionally, according to 2009 to 2010 claims data, the district showed an increased utilization of antidepressant drugs aligned with stress and depression.  Rather than just medicating or putting a Band-Aid on the issue, the district’s wellness team enhanced its Employee Assistance Program (EAP) to offer employee support and an ability to seek counseling to talk in person about issues or call a toll-free number to get professional referrals. 

The EAP, which is voluntary and confidential for employees, offers assistance for various emotional, financial, and familial issues.  This support and care helps employees maintain their productivity while working through challenges.  The EAP along with wellness and disease management programs are available at no charge to employees.  In a year-over-year comparison of 2009 versus 2010, the result of the EAP impact on the cost of mental health office visits included: 22 percent reduction in total claims, 26 percent reduction in medical claims, and 12 percent reduction in pharmacy. 

“Manatee has gotten in the driver’s seat to improve quality of employee care while simultaneously saving millions of dollars,” said Dan Ross, Med-Vision’s president.  “The district’s on-site team along with market-leading plan administrator, Blue Cross Blue Shield Florida, fully utilized health claim data analytics to create inspiring programs that are producing meaningful results for both the employees and the district.”

In early 2011, Kristi Dickerson, wellness coordinator for Manatee County School District, presented an overview of HealthVantage to an elite group of executives and decision makers at the Health Benefits Conference and Expo.  The employee wellness presentation, available at www.med-vision.com/manateeintro.html and titled “One Size Does Not Fit All,” reinforces that the key to the program’s success has been a team effort in customizing solutions for current employee needs.

About Med-Vision: Founded in 2005 and based in Tampa, Med-Vision delivers health plan risk management and wellness strategies 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 health plan members across the nation.  Med-Vision has helped corporations, healthcare facilities, municipalities, and school districts to reduce risk, reverse trends, and decrease healthcare costs while increasing quality of care for their employees.

About Verisk Health: Verisk Health, a subsidiary of Verisk Analytics, leverages healthcare data to help businesses 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, Verisk Health has created the most extensive independent risk assessment and decision analytics platform in the healthcare industry.