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November 6, 2020

Personalized Health Support Programs Have Greatest Impact on Results

By Josh Smith

In order to have a meaningful impact – on personal well-being and on the bottom line – health support programs must meet people where they are.

To know where your people are, you need to understand your data, as I discussed in my last blog. Once you know your data, you can address health holistically – across a continuum of needs – as we do at Portico.

Health Benefits Across the Continuum

At Portico, our goal is to provide health benefits that help our members create and maintain whole person well-being. That’s important because it’s a departure from the disease management model practiced by so many benefit plans. Those plans see health benefits primarily as a means to manage illness, rather than a way to promote health.

By starting from a place of well-being, members can often prevent chronic conditions like heart disease and diabetes before they happen. However, we still recognize that many chronic conditions persist and are often unavoidable, which is why we also serve our members with robust programs that help them manage and treat these conditions.

Total Well-Being Promotion

Starting at the healthy end of the continuum and reaching members throughout their health care journey, we offer Being by The Big Know. Being is a total well-being learning platform that features short, but powerful, video courses taught by best-selling authors, spiritual guides, TED speakers, renowned professors, celebrity chefs, and others.

Being is a gateway to many of our other health care programs, so we took the time to truly personalize it. We partnered with The Big Know to feature our own members in the videos and we added a faith-based component that speaks directly to those who serve across the ELCA community. We integrated our other health benefit offerings by connecting members with relevant resources. For example, a lesson on nutrition would end by connecting the viewer to Portico’s weight loss program.

Due to this high level of personalization, we see members engaging with Being for an average of 45 minutes per session as compared to The Big Know’s average book of business, which engages for 30 minutes per session. We also saw an impressive 87% completion rate for lessons taken in the third quarter of 2020, as compared to a book of business completion rate of 48%.

Chronic Condition Prevention

For those members identified as being at-risk for chronic conditions, we offer Omada™. This preventive program aims to reduce weight for at-risk populations to prevent future complications related to obesity like heart disease, diabetes, musculoskeletal disorders, and others.

Since inception in 2018, our members have lost 11,502 total pounds with an average of 9.3 pounds lost per participating member.

How does weight loss help prevent chronic conditions and reduce health care costs? According to articles published by the National Institutes of Health (NIH), the risk of diabetes is lessened by percentage of weight lost, as seen in the following chart:

  • 0-3% weight loss = risk reduction of 35%
  • 3-5% weight loss = risk reduction of 38%
  • 5-7% weight loss = risk reduction of 54%
  • 7-10% weight loss = risk reduction of 64%
  • >10% weight loss = risk reduction of 85%

When weight is reduced, we see cost savings and risk reduction. For example, according to the NIH, a 5% weight reduction can result in estimated annual medical cost savings of $2,137 for those with a starting body mass index (BMI) of 40. With the support of the Omada program, 600 Portico members who completed four lessons and were active for 16 weeks lost at least 3% of their body weight.

Chronic Condition Management

On the chronic condition end of the continuum, we offer a Diabetes Management Program through Livongo, which helps members make better diabetes management decisions via tools like a blood glucose meter and mobile app, and through coaches who are certified diabetes educators.

With Livongo, Portico’s participants have seen reductions in A1C (the standard test to measure diabetes management) levels that are below the ADA recommendation of 7%. These reductions matter to the long-term health of those living with diabetes. For instance, by reducing A1C by just 1%, they can help prevent:

  • Death from diabetes by 21%
  • Likelihood of a heart attack by 14%
  • Microvascular complications by 37%

When health is impacted in a positive way, so are costs. By better managing their diabetes, members can avoid costly emergency room visits. And when A1C is reduced by just 1%, Livongo participants see a savings of $73-$99 per month.

Offer Programs Based on Needs – Not Incentives

The results I’ve shared show that these programs truly work to improve outcomes and costs, and I want to point out that we achieve these results without offering financial incentives to participate. Instead, we follow the data found in health risk assessments, medical claims, Employee Assistant Program usage, and industry data.

By leveraging this data, we can understand what our members truly need from their health benefits and how to effectively engage them, whether that’s weight loss to prevent future complications, better diabetes management and prevention, or access to meaningful mental health resources.

We know that we can only achieve sustained, positive change when our members truly believe in the programs and understand the benefits to them personally. That’s why we do the research, dig into the data, and personalize programs based on what our members need.

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Josh Smith

Josh is a strategic and innovative benefits professional willing to challenge the status quo. In his time at Portico, he 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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