N.J. health system employs value-based program

By deploying a value-based wellness program, the Solaris Health System has experienced a 17 percent cost reduction among employee participants diagnosed with diabetes.

"This drop can be attributed to the participants' successful engagement with the program," said Solaris CFO Pat Cooke. Engagement activities included annual eye exams and an A1c test every six months, as well as refilling diabetes medications.

The savings were calculated on diabetes per member per month (PMPM) costs from January 2008 through April 2009. The paid medical PMPM for eligible diabetic members within that timeframe was $1,071. From January 2009 through April 2009, paid medical PMPM decreased to $835, resulting in a $236 PMPM savings.

Prescription costs increased year over year because participants began taking their medication regularly, Cooke said. From January 2009 through April 2009, paid prescriptions PMPM was $220, an increase of $24 from the paid medical PMPM for eligible diabetic members from January 2008 through December 2008.

"Medicine adherence, which is an important part to proactive health management, is a key contributor to a successful value-based plan design," she said.

Nearly 29 percent of Solaris employees participated in the wellness program and were rewarded with such benefits as lower employee contribution and prescription drug co-pays, no co-pays for annual adult physicals and four hours of paid time off to complete annual checkups and screenings.

"We believe in the carrot vs. the stick," Cooke said. "You have to start by building a culture of wellness. This is the motivation that some people need."

Solaris deploys HealthInsight's value-based healthcare administration platform to identify and track health actions.

"There has been a lot of interest in the last 12 months in value-based plan design," said Janice Rahm, executive vice president at HealthInsight. Participation and compliance rates have gone up, which are being fueled by healthcare savings that participating organizations, such as Solaris, are reporting, she said.

Solaris is expanding and fine-tuning its program, which includes building on its robust communication platform to reach out to noncompliant members, Cooke said.

To maximize value-based plans, organizations need to communicate continually with members and consumers, said Jan Berger, MD, CMO of Silverlink Communications. "It's very important for consumers to understand what they're supposed to do and how to do it," she said.