Peer-reviewed, matched cohort analysis shows cost reductions of $167 per member per month, and reductions in avoidable emergency department and hospital visits
April 30, 2020, SAN FRANCISCO, CA—Collective Health and One Medical (Nasdaq: ONEM) recently collaborated on a peer-reviewed study published in JAMA Network Open to quantify the value delivered by a membership-based primary care model combining virtual, near-site and on-site care at one of the companies’ shared client—an American aerospace manufacturer and technology company.
This peer-reviewed study specifically analyzes the effectiveness of employer participation in an integrated primary care delivery model that includes virtual, near-site and work-site care. Past studies exploring workplace health programs have been limited to occupational health services, rather than comprehensive primary care that can be used for chronic disease management, behavioral health, and other major medical needs.
Key findings include:
- Members who utilized the One Medical care model for their primary care had lower overall health spending on a risk adjusted basis primarily due to overall lower utilization of services despite services costing more per utilization episode. This includes comparative cost reductions of $167 per member per month (PMPM).
- Decreases in spend in costly downstream care categories such as emergency care, hospital visits, prescription medications, and radiology, outweighed increases in lower-costing upstream services such as primary care and mental health. The study observed the following spending reductions:
- 45% lower total medical and prescription claims costs ($167 PMPM);
- 54% lower spending on specialty care ($11 PMPM);
- 43% lower spending on surgery ($14 PMPM);
- 33% lower spending on emergency department care ($16 PMPM); and,
- 26% lower spending on prescriptions ($5 PMPM);
- The study observed the spending increases on such lower cost areas as primary care and mental health services, which were more than offset by the downstream cost reductions seen in other spend categories:
- 109% higher spending on primary care ($20 PMPM); and,
- 20% higher spending on mental health care ($1 PMPM).
Methodology:
The peer-reviewed study was led by Collective Health, which administers health plans for businesses and enables employers to harness dozens of virtual health and care delivery solutions. Given the full range of payment and engagement information managed on its core technology platform, alongside its team of data scientists, statisticians, and actuaries, Collective Health helps facilitate population health programs. Conducting peer-reviewed studies, such as this with One Medical, allows businesses to better evaluate the value they and their employees are getting from virtual health and care delivery solutions.
This study is a retrospective analysis of the impact of One Medical’s membership-based primary care model, which combines virtual, near-site, and work-site care. The study compared approximately 1,980 of the shared client’s employees who were using One Medical for their primary care to a cohort of employees attributed to other primary care providers, matched on certain criteria. Collective Health’s platform ingested a variety of data including medical claims—all on a de-identified basis to protect member privacy—which allowed it to run two key analyses:
- A descriptive analysis of utilization and costs at the company level, comparing work-site, near-site, and virtual care utilization and cost by type of service to their community-based equivalents; and
- A matching-based analysis of utilization and cost differences among members who used the employer-sponsored integrated primary care delivery services for the majority of their primary care, versus those members who did not.
Quotes:
“There’s a lack of evidence on the effectiveness of emerging care models like on-site and near-site primary care,” said Dr Sanjay Basu, MD, PHD, Director of Research and Population Health at Collective Health. “It is essential to ensure that the evaluations of these solutions are conducted in a manner that leads to rigorous, peer-reviewed research for the community who decides whether such models should be pursued. And we believe we have an important role to play at Collective Health in facilitating evidence-based decisions for our clients.”
“At One Medical, we think of primary care as a platform for protecting lifespan, enhancing recovery and promoting wellbeing of people, while reducing costs. Combining virtual care with near-site and work-site clinics is proving to be a powerful way for employers to provide convenient access to preventive care, keep employees out of the ER, and lower avoidable costs,” said Raj Behal, MD, MPH, Chief Quality Officer at One Medical. “This study illustrates the value of implementing a modern primary care solution. When you create an effective healthcare home base for employees, you can see significant cost reductions by eliminating the need for more costly downstream care.”
About Collective Health
Collective Health simplifies employee healthcare with an integrated technology solution that makes healthcare work for everyone. With nearly a quarter of a million members and over 50 clients—including Driscoll’s, Pinterest, Red Bull, Restoration Hardware (RH), and more—Collective Health is reinventing the healthcare experience for forward-thinking organizations and their people across the U.S. The company has developed a range of population health management solutions, and partnered with innovative companies across care delivery and diagnostics to meet the most pressing healthcare challenges for employers today. Learn more at collectivehealth.com
About One Medical
One Medical is a membership-based and technology-powered primary care platform with seamless digital health and inviting in-office care, convenient to where people work, shop, live, and click. Our vision is to delight millions of members with better health and better care while reducing costs. Our mission is to transform health care for all through our human-centered, technology-powered model.
Headquartered in San Francisco, 1Life Healthcare, Inc. is the administrative and managerial services company for the affiliated One Medical physician-owned professional corporations that deliver medical services in-office and virtually. 1Life and the One Medical entities do business under the “One Medical” brand.