Larry BoressExecutive Director

NAWHC

C opyright © 2018 N AW H C

2

Source: Willis Towers Watson

C opyright (c) N AW H C 2018

Do you don’t know if your clinic has an ROI?

◦ 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

Source: Willis Towers Watson

} 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

} 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

} 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

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)

*NAWHC 2016 Clinical Metrics Survey

*NAWHC 2016 Clinical Metrics Survey

*NAWHC 2016 Clinical Metrics Survey

*NAWHC 2016 Clinical Metrics Survey

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

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

• 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

} Larry Boress} Executive Director} lboress@nawhc.org} www.nawhc.org

mailto:lboress@nawhc.orghttp://www.nawhc.org/