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Second opinion
Client
$95 billion global aerospace company
Problem
Second-opinion benefits were being utilized by employees with common, everyday ailments rather than those likely to require high-cost care for conditions such as back pain and cancer. This was caused by an inability to target sub-populations likely headed for major treatment who could benefit from a second opinion.
Goal
Increase second-opinion utilization for members at high risk for back, knee, hip, and neck surgeries, decreasing the expense of high-cost surgeries when better options exist.
Our approach
Generate target member list using high-volume claims data and predictive algorithms with engagement messaging guided by behavioral science.
Outcome
59 members consulted 2nd-opinion service for musculoskeletal conditions
$2.1 million avoided in unnecessary treatments*
10 members consulted 2nd-opinion service for prostate & breast cancers
$360,000 avoided in unnecessary treatments*
*Savings estimates provided by 2nd-opinion vendor
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