ABACUS HEALTH SOLUTIONS – Meet A Vendor
Shortlister hosted Dr. David K. Ahern, Abacus Health Co-Founder and Senior Scientist, to review Abacus’ chronic condition management program that keeps members engaged with the healthcare system and can mitigate the risk of future high-cost hospitalizations/claims.
THE EFFECT OF COVID-19 PANDEMIC ON EMPLOYER HEALTHCARE COSTS
Covid-19 has highlighted the limitations in the traditional approach to delivery of healthcare services and the structural inequities in health care. This created the need for increasing innovative ways for plan members to complete chronic condition care standards during a pandemic, and the data just confirms that.
- 3 in 5 US adults have avoided or delayed in-person health care
- 1 in 3 Americans who have a chronic health condition say their condition has worsened
- 1 in 5 Americans skipped or delayed blood work or lab testing
DIABETES CARE REWARDS PROGRAM OVERVIEW
Abacus’s diabetes care rewards program is a patented behavioral science model that engages members with diabetes in preventative care. It supports team members and covered dependents with:
1. TARGET BEHAVIORS
Provider Engagement is proven to reduce hospitalization and to close the care gaps.
Telehealth Support is part of the Diabetes Health Action Plan® that includes a personal approach that focuses on Care Coordination and supports other complicating conditions.
2. BEHAVIOR-CONTINGENT INCENTIVES
Members receive a zero-co-payment waiver on anti-diabetic medications and supplies and it procures savings of more than a hundred dollars per month.
As an addition Abacus program also includes:
- Remote monitoring and control that provides actionable data based on the clinical need of each patient and allows advanced patient engagement and pattern analysis.
- A personalized messaging platform that gets information from both biometrics and screenings and exams, Diabetes Health Action Plan, and claims data to support the identification of risk profiles for members.
- Artificial Intelligence (AI) & Machine Learning to identify which members are most likely to participate, need monitoring and guide personalized health interventions, and identify future risk to avoid hospitalizations.
FORTUNE 500 COMPANY CASE EXAMPLE
Abacus has been working with a Fortune 500 company for the last three years. Their case example represents a care coordination approach between Abacus, the administrative health plans, and the onsite clinic to engage members in quality care using the latest in telehealth services and coordinated care solutions.
FORTUNE 500 COMPANY CASE EXAMPLE
A controlled study of the Diabetes Care Rewards program demonstrated the following results:
- 19% greater likelihood of a physician visit over a 12-month follow-up
- 38% lower all-cause hospital admissions
- 34% fewer hospital days
- 20% decrease in members with HbA1c > 9 and 30% Increase in Rx adherence
- 21% lower medical trend
Despite all the uncertainty we faced, the pandemic highlighted the critical importance of ongoing management of chronic illness, brought advancement in the utilization of telehealth and telemedicine and care delivery, and increased attention and efforts to address disparities in health care.
Abacus Health Solutions is effectively aligning the latest health and wellbeing strategies to optimize plan performance with proven ways to change long-term health care cost trends.
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