How Value-based Solutions Drive Better Health Outcomes and Savings

As the prevalence of chronic conditions grows, the more urgent the need for health care solutions that engage patients to improve health outcomes, while also controlling costs.

Today, the majority of U.S. adults – six in 10 – live with a chronic condition, such as cancer, diabetes, and heart disease, among others. What’s more, four in 10 suffer from two or more chronic conditions. These conditions are a top driver of the country’s $4.1 trillion annual health care costs.

Value-based care solutions are no longer a nice-to-have, but a must-have for plan sponsors and patients.

Engaging patients by using health tools

Leaving chronic conditions unmanaged may result in disease progression and comorbidity development. Additionally, it may lead to excess spending on emergency department (ED) visits and even hospitalizations.

Through value-based care solutions, plan sponsors can give patients tools to manage conditions on their own terms. Using these tools, patients can stay up to date on their care. These tools and support range from coaching to condition-specific digital resources, like a cellular connected scale for weight loss. They complement a care strategy of routine check-ups, screenings, and patient education, driving meaningful clinical outcomes.

Addressing medication spending 

Another way value-based solutions reduce expenses is by driving patients to the most cost-effective and clinically appropriate medication.

It could be approval of a generic medication that offers the same effectiveness as a brand-name medication, or a biosimilar approved as a substitute for an original product. No matter the scenario, value-based solutions steer patients toward the most appropriate treatment.

Value-based solutions use a number of strategies to bring down the cost of medication. These include early discontinuation reimbursements and indication-based management, a type of utilization management that considers the patient’s response to therapy, current marketplace dynamics, and future trends. Such evaluation helps ensure patients have access to the right medication at the right price.

When plan sponsors employ value-based care solutions to address medication spending, they can:

• Reduce costs and eliminate waste
• Improve patient adherence to medication and persistence with treatment
• Improve the total cost of care through higher rates of therapy completion and compliance with clinical guidelines

Better outcomes lead to maximized health plan value

Patients benefit from education and support to help them take medication appropriately, ensure medications work as intended and improve their overall health. When plan sponsors provide these resources, they improve health outcomes and achieve savings. In 2022, SafeGuardRx saved enrolled clients more than $6.4 billion. Other outcomes include:

• Improving medication adherence – The Evernorth SafeGuardRx platform encourages adherence through outreach to patients along with coaching to discuss their medication. As a result of these outreaches, the number of patients filling their prescription within 30 days increased by 11% in 2022.
• Helping patients lose weight – Now more than ever, patients are reliant on health tools they can access from anywhere. There are a variety of digital tools and support available through SafeGuardRx programs. 81% of patients enrolled in Weight Management Care Value and Diabetes Care Value programs lose an average of 3.6% of their body weight.
• Controlling drug trend – Plans enrolled in SafeGuardRx Diabetes Care Value saw a 7.1% lower drug trend compared to those not enrolled in the program in 2022.

Value-based solutions give patients tools to take charge of their health and plan sponsors an opportunity for cost-containment. As the population of patients with chronic conditions grows – along with the number who suffer from comorbidities – these solutions only become more necessary.