Nick Brecker*, President, Specialty Business, Anthem Blue Cross and Blue Shield

Jeff Spahr, Vice President, Specialty Business Development, Anthem Blue Cross and Blue Shield

What if you could lower health care costs, improve employee health outcomes and boost productivity in the COVID-19 ‘new normal’ environment? It may seem too good to be true, but all those things are possible by integrating data and care management across employee benefit programs.

Historically, most employers bought their various benefit plans (Medical, Pharmacy, Dental, Vision, Disability, etc.) from different companies that couldn’t effectively coordinate across products. However, recent innovations have created significant value in packaging these products together in a way that improves outcomes for employers and employees. Consider the following results that Anthem Blue Cross and Blue Shield (Anthem) has achieved for our clients through an integrated benefits strategy:

  • Average annual medical costs approximately nine percent lower with integrated medical and pharmacy; saving about $368 per employee.
  • When integrating medical and dental benefits, employees’ annual medical and prescription costs average $4,000 less for high-cost cardiovascular conditions, and the frequency of prescribing opioids can be cut in half.
  • When plans are purchased together from a single carrier, administrative costs are lowered, and premium rates are often reduced on one or several coverages.

Since 2014, Anthem has tracked employers’ interest and adoption of integration through our biennial Integrated Health Care Survey (IHC). The most recent survey conducted this year found that 56 percent of employers are now actively integrating their benefit programs, up from 33 percent in 2016. Almost 75 percent of those integrating are choosing to do so with a single carrier.

While employers continue to offer competitive benefits to attract and retain talent, COVID-19 has made greater affordability and administrative simplicity key priorities. New challenges are also emerging to effectively meet the needs of employees working remotely and manage absenteeism and workforce productivity.

Anthem’s new approach to ‘Whole Person Health’ gives Medical, Dental and Vision care providers a more complete picture of each individual’s health history across benefit programs,  in order to better diagnose and treat health conditions and identify potential gaps in care. This information is then shared between the health care providers, members and care management teams to drive better engagement and outcomes. To further encourage employee engagement, participants can also conveniently receive ‘care alerts’ over their smart phones and other digital applications.

Lowering costs

Integrating benefit programs can lower costs through increased engagement and early detection of gaps in care, where proactive care is often less expensive than reactive care. For example, through Anthem’s Whole Health Connection®, 33,000 members were identified as having diabetes through eye exams in 2019. Diabetes is one of the most common chronic conditions impacting health care costs, and early identification of diabetes can save $1,000 per individual, meaning IHC created a cost savings of up to $33 million through eye exams alone.

Improving health care outcomes

Better employee health reduces health care costs and the number of workdays missed due to injury or illness. For example, research has linked periodontal disease with the risk of cardiovascular disease—the leading cause of death for men and women in the U.S.—primarily due to infection from the mouth entering the bloodstream and going to the heart. Because Anthem has connected physicians and dentists and data across products, we have greater health insights than any standalone dental carrier. It’s also easier to coordinate outreach and care management programs to those high-risk individuals driving higher medical costs. As a result, certain individuals diagnosed with cardiovascular disease have a 20 percent lower incidence of heart attack when Anthem Medical and Dental plans are integrated compared to those individuals who have Medical and Dental through separate carriers.

Creating a better health care experience and improving productivity

Digital tools have enabled an enhanced, individualized experience for employees. In fact, 92 percent of employers agree digital capabilities are important in engaging employees in their health. Anthem offers members the Sydney mobile app, a personal health ally using data, predictive analytics and AI to identify opportunities to improve health, reduce health care spending, and mitigate critical health issues. Thanks in large part to Sydney, Anthem closed over two million dental and vision care gaps in 2019.

In addition to all of the above, integration can improve productivity by accelerating the disability claims process. Medical and Disability clinicians and case managers can assess each member and provide the necessary support to pay claims quicker, reduce their time away from work, increase engagement and improve health outcomes. This has resulted in an average of three-day decision times for new disability claimants versus an average of five days without integration and 24 percent of disability claimants returning to work early.

Continuing momentum

It’s clear that an increasing number of employers are finding innovative approaches to integrate benefit programs to lower costs, improve health care outcomes and positively impact the consumer experience and workforce productivity.

Perhaps the more important question to ask is why wouldn’t you have an integrated benefits strategy?

*After 17 years with Anthem Blue Cross and Blue Shield, Nick Brecker announced he is retiring in October, but he will continue to advocate for an integrated health care and whole person approach to health care as a consultant to employers and brokers.

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