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Larry BoressExecutive Director
NAWHC
C opyright © 2018 N AW H C
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2
Source: Willis Towers Watson
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C opyright (c) N AW H C 2018
Do you don’t know if your clinic has an ROI?
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◦ Preventive care Employees receiving
appropriate screening as a percent of all eligible employees
◦ Program participation Participating employees as a
percent of eligible employees◦ Utilization
Employees receiving medical care as a percent of all employees
◦ Employee Satisfaction◦ With providers and services◦ Employee engagement
Average health engagement survey score per employee
}
◦ Health risks Number of health risks per employee
◦ Biometric screening Employees meeting clinical targets as
percent of all employees◦ Chronic conditions
Employees with chronic conditions as a percent of all employees
◦ Financial Total health-related program cost per
employee/avoided ER visits◦ Lost time from work
Number of lost workday equivalents per employee from health-related conditions
◦ Lost productivity-absences◦ Recruitment and Retention
Improvement
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Source: Willis Towers Watson
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} Goal: Provide an objective approach to VOI• To create recommendations on performance metrics and
methodologies in the financial, administrative, clinical and satisfaction areas
• To promote the recommendations for use in RFPs, evaluation of the performance of clinics and to compare vendors offering similar services
} Approach:• Literature search conducted to identify previous work on clinic
performance evaluation• Surveys sent to members and others to determine how many are using
various metrics, how they are defining and using them and if there are additional metrics to add
• An online roundtable discussed the findings and core measures• A project committee made the final recommendations
C opyright (c) N AW H C 2018
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} Areas to measure:• Administrative• Financial• Clinical• Satisfaction
} The number of measures and drill down is not the same for all employers or clinics:• Time frame measurement is to be done• Extent of services• Length of clinic existence• Interest in drilling down
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} What should be in the numerator and denominator? It depends on:• Whether you want to look at the “%” or the “#” of people in a
category• Whether you look at the employer’s:
• Total population;• The population who is covered;• The population who is eligible to use the clinic; or
• The population that actually uses the clinic• How a ”clinic patient” is defined
} You need to decide on these at the start, as employers, vendors and providers have different definitions
} Comparisons with other employers are difficult unless they agree on these elements in the calculation
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Source: N BG H
82%73%
100%91%
36%
64% 64%
27%
100%
FINAN
CIAL
CLIN
ICAL
IMPR
OVEM
ENTS
PROG
RAM
PART
ICIPA
TION
PATIE
NT SA
TISFA
CTIO
N/EX
PERIE
NCE
BEHA
VIORA
L CHA
NGE
PREV
ENTIV
E CAR
E PRO
VIDED
BIOME
TRIC
SCRE
ENIN
GS
UTILI
ZATIO
N OF
OUT
SIDE S
ERVIC
ES
UTILI
ZATIO
N OF
CLIN
IC SE
RVIC
ES
(Source: NBGH)
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*NAWHC 2016 Clinical Metrics Survey
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*NAWHC 2016 Clinical Metrics Survey
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*NAWHC 2016 Clinical Metrics Survey
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*NAWHC 2016 Clinical Metrics Survey
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73%
64%
36%
27%
45%
18%
36% 36%
55%
45%
Med
ical
cos t
var
ianc
e
ER v
isit s
avo
ided
or
redu
ced
Phar
mac
y sa
v ing
s
Gene
r ic p
resc
r ibi
ng ra
te
Spec
ialis
t car
e av
oide
d
Spec
ialis
t net
wor k
sav i
ngs
Case
man
agem
ent s
avin
gs
Hosp
ital
inpa
tient
sav
ings
Savin
gs f
rom
risk
red
uct i
ons
Per M
embe
r Per
Mon
th
Source: N BG H
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40%30%
20%
70%
10% 10%
30%
0%10%
20%30%40%50%
60%70%80%
Reducedinjur ies at
w ork
Reducedabsences
Inc reas tedpro duct ivit y
Saved t imeaway fr om
w ork
Reducedtur nover
impr ovedret ent ion
rate
O ther
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• Decide on your objectives for the center and plan to measure them• Create the measurement approaches you need to gauge success• Define and get agreement on your numerators and denominators from
those responsible for reporting• Make sure your vendor/provider has the understanding of your
objectives, measurement needs and reporting requirements and has state of the art ROI and VOI tools to meet expectations
• Create performance guarantees with contractors based on your objectives and targets
• Set expectations of senior management on VOI, not ROI, as cost savings and behavioral change could take 3-5 years
• Use results for reporting to support increased resources for expanding and improving center services
• Monitor reports for areas of improvement frequently• Make changes as needed
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} Larry Boress} Executive Director} [email protected]} www.nawhc.org
mailto:[email protected]://www.nawhc.org/