Practice the 4Ps: *EPMA Journal, 2010
Cafeteria Plan structure
Qualified medical expense coverage
HIPAA-compliant and legally protected
Step One
Predictive model predicts onset of a disease before symptoms
Combine objective & subjective data
Synthenalysis combines various studies to determine what causes certain conditions
Predictive analytics provides earlier risk Intervention before organ damage
Validation of the predictive pre-disease risk categories
Step Two
Proprietary analytics
Identify risk burden-potential risk and cost avoidance/exposure for each condition
Project cost and productivity savings
correlates pre-disease long term health risk costs which can identify up to 60% savings opportunity per at risk individual.
Forecast known risk and cost progression
Average spend of members receiving care is approximately $7188/year*
Step Three
Identifies and improves the existing medical conditions before they become symptomatic and later stage
Manages pre-clinical/pre-symptomatic conditions before becoming clinical, symptomatic, full blown disease
Manages acute clinical/symptomatic medical conditions to a regression state and improved outcomes
Early intervention and proactive, guideline driven care management
Step Four
Guideline focused proactive care management
Prevention of complications and end-stage problems
Identifies incorrect disease management by gap analysis
Provides long term continuum of care
Proven enhancement of health outcomes and lower costs
Step Five
Follows physician disease management episodic activities by patient
Tracks utilization & costs
Identifies treatment gaps
Step Six
Claims and health plan analysis to track and formulate new strategies
Tracks claims adjudication expenses
Health plan expenses disease & procedure claims
Provider & drug distribution activities
BY INTEL-GE CARE INNOVATIONS
Reduce the incidence of ER visits and hospitalizations between 80 and 93% using the PredictiMedTM AI system.
Studied over 15,000 cases over 5 years
Compared prediction with diagnoses
80%-93% accurate in predicting the onset of disease prior to symptoms
Provides organizations with unbiased, third-party evaluation to ensure its assessment methodology is sound, which is critical in building population health programs that will help those who are sick better manage their health and prevent those who are at-risk from developing costly chronic conditions.
In 2015 The Institute had the opportunity to validate PredictiMed’s ability to identify and lower the pre-disease high risk level, which may precipitate a higher use of ER and hospital services, in thirteen major disease categories to a lower level where the preemptive intervention can be applied and thus reduce the incidence of ER visits and hospitalizations between 80 and 93%.
Front Windshield Approach
Direct Medical Costs
Pre-disease Risk | Significant Risk Cases | Financial Risk Burden |
---|---|---|
Heart Disease (Male) | 40 | $1,091,890 |
Back Problems | 63 | $971,038 |
Lung Cancer | 27 | $519,381 |
Hypertension | 191 | $517,035 |
Colorectal Cancer | 24 | $386,131 |
Diabetes | 158 | $277,228 |
Breast Cancer | 13 | $242,659 |
Prostate Cancer | 19 | $178,632 |
Heart Disease (Female) | 4 | $109,189 |
Peripheral artery disease | 5 | $75,553 |
Stroke | 5 | $55,275 |
Depression | 20 | $54,291 |
Total: | 593 | $4,908,611 |
Total Pre-disease Risk Burden per HRA participant [593] = $8,250
Pre-disease USHC book of business range = $6,000 - $12,000
Significant risk = Ticking time bombs
Data driven model
Participant incentives, provider incentives, engagement & activation, communication benchmarking, and goals monitoring.
Analyze and predict future condition risk and future costs.
Physician steerage, financial incentives, wearables, outcome monitoring, reimbursement tracking, and management.
Age / Gender / Ethnicity / Lifestyle / Biometrics / Medical Hx / Rx / Genetics
Education / Lifestyle Modification / Risk Verification / Pre-emptive Intervention Disease Management / Self Care / Large Case Management / UR
Analyzes medical and Rx claims, care gaps, utilization
Personalized engagement, PHR protocols, videos, lifestyle management, incentives, content
Wholeistic coaching track, stratify, manage disease, pre-disease and lifestyle, behavioral health, large case, UR, Precert, disease management
Incentive design, tracking, reporting, events, activities, RAS Payroll, HSA integration, eligibility management
Customize content on PHD, educate, steer members, modify protocols, surveys, videos, etc.
Fact based decision support, costs, readiness, interest, ROI, trending, strategy
3-Year Risk Migration Repeat Participants
4,616 individual repeat participants in 24 unique customers
2,009 cases mitigated across 9 conditions, 24.3% improvement in significant risk cases of elevated, high or serious
Total of $16,036,808 or $7,982 per case of risk burden reduction
Year One
Year Three
THIS IS NOT INSURANCE
Services
What Is Covered
What is NOT Covered
Who We Serve
Our Team
16415 Turnberry, Belton, MO 64012-7820
THIS IS NOT INSURANCE
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Life on the road can be demanding, and your health should not take a back seat to your career. Long hours, unpredictable schedules, and limited access to healthcare can make staying healthy a challenge for OTR truck drivers. Studies show that unmanaged health issues can lead to missed workdays, increased stress, and long-term health complications – all of which can affect your livelihood and quality of life.
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Life on the road can be demanding, and your health should not take a back seat to your career. Long hours, unpredictable schedules, and limited access to healthcare can make staying healthy a challenge for OTR truck drivers. Studies show that unmanaged health issues can lead to missed workdays, increased stress, and long-term health complications – all of which can affect your livelihood and quality of life.
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A virtual health platform offering comprehensive services tailored for Over-the-Road (OTR) truck drivers can significantly enhance their health and well-being while addressing the unique challenges of their profession. Here is how:
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Language Support: Multilingual services for a diverse workforce.
Valuable Employee Benefit: Enhances job satisfaction and reduces turnover by prioritizing drivers health.
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Price includes the entire family.
All visits included in plan are administered virtually.
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