LAKE FOREST, Ill. – YourCare, an integrated population health management program from CoreSource, has led to increased compliance with evidence-based standards of care and more appropriate utilization of the healthcare system by members who participate in the program, according to a comprehensive analysis of the program’s first-year results released this month. CoreSource is a leading national provider of administrative and health management services for self-funded employee benefit plans.
“When we rolled out the YourCare program to our clients almost two years ago, our goal was to maximize the health potential of their plan members, regardless of health status,” said Paul Lotharius, CoreSource President and Chief Executive Officer. “With more than a full year of data under our belts, we’re very pleased that the early results seem to indicate that we’ve done just that.”
During the analysis period, YourCare had three core components:
- Personalized reminders for plan members who are overdue for age-and gender-appropriate tests and screenings such as mammograms and colonoscopies;
- Notifications to plan members with chronic conditions and their primary care physicians when members have gaps in evidence-based standards of care for their condition; and
- Phone-based disease management from registered nurses for plan members whose costs have been relatively low to date, but who are at highest risk for incurring significant costs in the next 12 months.
In its analysis of YourCare’s first-year results, CoreSource reviewed medical claims data for 16 self-funded employer clients (with a total of 13,687 employees and approximately 29,120 covered lives) that implemented one or more YourCare programs during the first quarter of 2008 and had the programs in place through March 2009. YourCare programs are driven by a CoreSource analysis of employer’s medical and pharmacy claims using VeriskHealth’s D2Explorer data analytics engine.
The analysis focused on members with one or more of five chronic conditions targeted during the initial rollout in January 2008: diabetes, coronary artery disease, congestive heart failure, asthma and chronic obstructive pulmonary disease.
Some highlights of the analysis are:
- On average, nearly 50 percent of the members diagnosed with one of more chronic conditions closed at least one gap in care during YourCare’s first year. An analysis of the CoreSource book of business showed that long term, members with chronic conditions who are compliant with recommended standards of care cost 4 percent to 13 percent less than those who are non-compliant.
- Compliance with preventive testing for cancer increased over the course of the year for members in potentially at-risk demographic segments. For example, mammogram compliance increased 6 percent, Pap smear compliance increased 5 percent, and colorectal screening compliance increased 4 percent.
- While groups in YourCare programs saw a 12 percent increase in office visits during the first year, they had a corresponding decrease in more expensive emergency room visits (down 6 percent) and hospital admissions (down 17 percent).
“To reduce the use of expensive healthcare services, we recognized that physician office visits would have to increase so that members and their physicians could best manage chronic disease,” said Donna Heiser, Vice President of Healthcare Management for CoreSource. “We created a program to improve the health status of our members and to reduce healthcare costs for our clients, and we’re so pleased that we seem to be heading in the right direction on both counts.”
CoreSource is one of the nation’s leading TPAs, delivering integrated, customized employee benefit solutions to self-funded employers. CoreSource utilizes cutting-edge products and services designed to facilitate effective cost-containment strategies. CoreSource is a subsidiary of Trustmark Mutual Holding Company. Trustmark has assets of more than $1.7 billion and, through CoreSource and other subsidiaries, administers more than $2.5 billion in health and life benefits annually. For more information, visit www.coresource.com.