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October 6, 2020

Leverage Data for Better Outcomes and Lower Healthcare Costs

By Josh Smith

In my last blog I discussed how it’s possible to keep healthcare benefit costs down without shifting the financial burden to employees.

While I explained Portico’s model at a high level, in this blog I’d like to dig into the data behind our decisions and show you how we used it to design benefits that achieve better outcomes and lower costs.

As you’ll see, Portico faces unique challenges in providing benefits, but that doesn’t stop us from following the data and doing what’s right for our members. By tracking and learning from data, we can invest in programs that truly meet members’ specific needs. As you think about benefit plans for your organization, I hope that you’ll consider the role data can and should play in your decision.

Know Your Data

Before we can design benefit packages that truly meet members’ needs and in turn reduce healthcare costs, we need to know more about the people we serve to understand which programs will be most beneficial. Specifically, it’s important to examine:

  • Geography
  • Age
  • Most prevalent conditions
  • Type of work performed

At Portico, we know our membership well, but we continually look at those four key indicators to make sure our benefits are evolving with our members’ needs. For the 2020 additions to our health benefits we looked at trend data for 2017, 2018 and the first two quarters of 2019 data.

Geography: We serve a diverse membership that includes people living in dense urban areas to remote rural communities, which means access to both standard and specialized health care and to wellness services varies greatly based on where people live.
Age: We serve a range of ages, from pastors nearing retirement to young workers just getting started. With a median age over 50, our sponsored members are older than the average employer plan and often more likely to have chronic conditions.
Most prevalent conditions:  Mental health conditions and hypertension (a precursor to heart disease, diabetes and other illnesses), are among the most prevalent conditions experienced by Portico’s members.
Type of work performed: Portico serves pastors and church workers as well as people working in other ELCA-affiliated organizations like nursing homes, hospitals, and social agencies. Many of these roles are mentally and emotionally taxing which means we see members reporting high levels of anxiety and depression.

Based on this data achieving our goal of improving our members’ health while keeping costs in check may look challenging. But we did it. How? We used data to design the right benefits.

Virtual Care Levels the Geographic Playing Field

Because our members don’t all have the same access to healthcare systems where they live, we seek to continuously improve access by adding to and strengthening our virtual care options. And while we could not have foreseen the current pandemic, these virtual care options have also helped members receive health care at a time when many are unable to make in-person doctor visits. In 2020, we bolstered our virtual health offerings with:

98point6®

This service provides non-emergency virtual access to board-certified physicians via secure in-app messaging.

Learn to Live®

This clinically-validated cognitive behavioral learning program has proven results on five treatment tracks: depression, anxiety, sleep, stress/worry, and substance abuse.

Being by The Big Know

This holistic health learning platform features video courses taught by best-selling authors and leading health researchers, and we went so far as to tailor it to our population by providing multiple custom courses and a faith-based personalization.

Tailored Prevention and Management Programs Address Age and Chronic Conditions

Age and chronic conditions often go hand-in-hand, and our data showed us that our members need to both prevent and to manage chronic conditions related to hypertension, like obesity and diabetes. We researched and chose the following leading programs based on their excellent track records:

Omada®: Chronic Condition Prevention

This preventative program aims to reduce weight for at-risk populations to prevent future complications related to obesity, like hypertension, heart disease, diabetes, musculoskeletal disorders, and others, including risk factors related to COVID-19.

Livongo®:  Chronic Condition Management

The Livongo for Diabetes Program® helps members make better diabetes management decisions via tools like a meter and mobile app, and through coaches who are certified diabetes educators.

Mental and Emotional Health Benefits Help Meet Members’ Unique Needs

In part due to the caregiving nature inherent in many of our members’ professions, we knew that mental and emotional health were key concerns. When we analyzed our mental health benefit use, we found higher-than-average utilization of the Employee Assistance Program by Beacon Health® and high self-reported levels of anxiety and depression. We addressed these needs through new online benefits, which I discuss in depth in a previous blog, New Mental Health Benefits Prove Their Worth During Pandemic and related Case Study.

Staying Ahead of Industry Trends

While we tailor our programs to meet the specific needs of our members, we don’t work in a vacuum. Industry analysis shows that we’re actually ahead of large companies looking to control healthcare costs.*

What This Means for You

Benefits selection must start with your people – their needs, their conditions, their well-being. By understanding their data as well as industry data, you’ll see the big picture and can then design solutions that will have the biggest positive impact on your people and on your organization. In my next blog, I’ll share exactly how this data driven approach yields positive results like lowering risk factors and raising engagement levels.

* Business Group on Health. 2021 Large Employers’ Health Care Strategy and Plan Design Survey, August 2020.

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Josh Smith

Josh leads the products unit of Portico, overseeing health, retirement, survivor, and disability programs and products that enhance the well-being of plan members. Since joining Portico, he has led a transformation in health plan design with innovative offerings that empower members and the organizations they serve to more effectively control costs and improve outcomes.

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