Life-Changing Results from the Closed Loop

 In Thinking

Earlier this year, I wrote about why our commitment to the closed loop is so vital, and how it leads to real outcomes. Now, I’d like to examine the loop a little closer. Even incremental changes can cause a major impact on the bottom lineboth for the business investment and in people’s lives.

Little reminders can make a big difference

As of 2015, only 8% of Americans over 35 were receiving all of the high-priority preventive services recommended for themthings like blood pressure and cholesterol checks, cancer screenings, and vaccinations. With everything working adults have to balance, it’s common for preventive care to fall to the bottom of the to-do list.

But delaying relatively easy (and relatively inexpensive) preventive care allows underlying health problems to go untreated, making them harder and more expensive to treat when they start to present a real threat.

That’s why we’re so committed to closing gaps in careand have been since we started.

How we do it

Closing gaps in preventive and chronic care is a key function of the closed-loop system. To do it, we start with the recommendations of the U.S. Preventive Services Task Force and the NCQA’s Healthcare Effectiveness Data and Information Set. We then run individuals’ age, gender, and claims data against these rules to get a detailed picture of who’s due for what care.

From there, we nudge peoplefirst electronically, and, if that doesn’t inspire action, through paper mail. This ensures that we reach 100% of people who are due for important care.

Soon after, we analyze claims data to see who acted on the message. From this, we’ve been able to see some pretty amazing outcomes, such as when 111 employees of one company got screenings that helped them avoid colon cancer, all in response to a nudge from Evive.

Determining how many people avoid cancer and other serious diagnoses due to nudges isn’t as simple as tallying up the number of people who got the nudge and then the screening. It involves crunching claims data, epidemiology statistics, and even employee turnover rates to arrive at an accurate estimate of how many future cancer treatments we helped them avoid.

Had those 111 people skipped their screening, the cost of treating them all for late-stage colon cancer would have amounted to about $17.8 million. Removing the potentially cancerous polyps, on the other hand, cost an average of just $794 per person. The net savings for the employer? More than $13 million.

Seeing the loop from every angle

Amid the data, it’s important not to lose sight of individual experiences. In our monthly sentiment survey, one MyEvive member who received a nudge to get a blood pressure check she was due for wrote, “I appreciate the little reminders here and there. A lot of the items are not big, but they can be important.”

It goes to show that even when a screening doesn’t result in something as dramatic as an early cancer detection, the simple act of getting one done has several positive effects:

  1. It delivers peace of mind. Getting care, whether preventive or diagnostic, moves people from uncertainty to certainty. And that’s empowering: It puts an end to unease and speculation (and to putting off care out of fear of the worst).
  2. It makes them more likely to seek recommended care in the future. When a person takes action for their healthfor instance, by getting a flu shotthat action is integrated into their self-concept (“I’m someone who gets flu shots”). Behavioral science tells us that, from there, they’re more inclined to act in a way that’s consistent with that self-concept.
  3. It saves money. For one employee population, the average difference between the cost of polyp removal and the cost of treating one person for late-stage colon cancer was about $159,000. In other words, preventive care pays.
  4. It closes the loop. When we receive claims data indicating someone got their recommended care, we replace the earlier nudge with whatever’s most relevant now.

It doesn’t stop there

The closed loop isn’t just about increasing adherence to care recommendations. It’s also about finding unexpected opportunities to give employees more of what they needincluding benefits that go beyond health.

For instance, when employees of one company took our benefits survey, the results revealed that 27% of them had pets at home. The company responded by offering a new benefit: discounts on pet insurance. Next, we leveraged the data we’d gathered from the survey to tell the pet owners their employer was now providing discounts on pet insurance. Loop, closed.

We’re always measuring outcomesand always seeking new avenues to improve the outcomes even more. Loop after loop, our approach gets smarter over time, showing us what works so we can do more of it.