How Salesforce Innovated an MSK Benefits Strategy and Reduced Medical Claims by 60%

December 7th, 2020  by  Gina Hanrahan and Grace Gaddi – Director of North America Benefits and Senior Manager of Global Benefits, Experience, and Delivery

At Salesforce, we wanted to change the narrative of employee health by creating friction-free pathways to access care. Because our workforce is relatively young, many of our employees have not yet learned how to navigate the complex healthcare system. Through our focus groups, we heard horror stories of employees trying to navigate the system and how hard it is to obtain care. As a result, our benefits goal is to simplify the process and make it easier for our employees to find the most effective and personalized care. Offering easy access to virtual healthcare, like Hinge Health’s Digital Musculoskeletal (MSK) Clinic, was a key part of our benefits strategy, which has only been amplified with remote work during the pandemic. The results? Our employees enjoyed easier access to virtual MSK care as well as better health outcomes, and we saw a 60% reduction in our MSK medical claims over a three-year period.

We recently shared our benefits best practices on a webinar hosted by Employee Benefit News along with Daniel Perez, CEO of Hinge Health, and Josh Dunsby, principal of Total Health Management at Mercer. Here is a summary of what we shared. Watch the webinar on demand here.

Founded in 1999, Salesforce is the world’s number one customer-relationship-management platform. We’ve helped over 150,000 companies unite their marketing, sales, commerce, service, and IT teams to work as one from anywhere so they could keep their customers happy everywhere. At Salesforce, we call our employees our ohana, which means family. As in other tech companies, much of our ohana is made up of young office-bound and jet-setting employees. While we’re headquartered in San Francisco, California, our workforce was dispersed all over the country before COVID-19. Now, in the COVID-19 pandemic, much of our workforce is remote.

Creating a frictionless healthcare experience

As mentioned, our benefits goal is to simplify the process and make it easier for our employees to find the most effective and personalized care. We look for solutions that help employees find the best high-quality providers and offer a one-stop-shop for employees instead of relying on multiple different providers. We want to streamline the process for employees, saving them time and providing easy access to the right care at the right time. Personalization is also an important benefits goal. We strive for a high level of personalization and tailor our programs to how Salesforce employees will be inclined to use them, which allows us to serve them at every stage of their lives.

Supporting our remote workforce during COVID-19

At Salesforce, we’re always pushing the envelope when it comes to offering cutting-edge healthcare benefits. As a result, the company had many key virtual healthcare benefits already in place long before COVID-19 hit, including Hinge Health’s Digital MSK Clinic. This enabled Salesforce to seamlessly continue to deliver virtual healthcare during the pandemic and keep our employees safe. During the COVID-19 pandemic, we’ve seen a significant uptick in use of these virtual healthcare benefits.

We also partnered with our marketing engagement team and launched our “Rethink Your Care Campaign” to let employees know their healthcare is still top of mind. The campaign helped inform employees that they can still access their healthcare virtually and obtain preventative care or treatment for chronic conditions.

In addition, to support remote work during the pandemic, we revamped our ergonomics program with online tools, modules, and virtual consultation ergonomics. For example, we have employees take photos of their home office space for our ergonomics consultant to evaluate. We expanded our family leave program to include more types of time off, such as caring for children due to school closures or taking care of a sick loved one. We also offer a backup child care stipend that could be used to cover school expenses like hiring a tutor to support distance learning. Finally, we enhanced our mental health support, including daily BeWell support meetings.

Adopting a virtual MSK solution to provide friction-free care

When we look at our medical claims data, MSK (back and joint) pain is the category with the most claims and has been for years. While our population is young and our workers don’t have a lot of other chronic conditions, they are often sedentary office workers on computers all day with a high incidence of back pain. At the same time, we also have our share of “weekend warriors,” people who are active in intense sports activities such as skiing or rock climbing that can also lead to chronic back, knee, shoulder, and other joint issues.

These facts motivated us to adopt a digital MSK solution like Hinge Health long before it was trendy. Now, with remote work and lack of daily movement during the pandemic, we’re very pleased to have offered this program to our members and to have achieved a 60% reduction in our MSK medical claims over a three-year period.

Hinge Health offered a personalized experience for our members

At Salesforce, we challenge our vendors to think out of the box and customize their experience based on our employees’ needs. We wanted to know what the member journey was like. We don’t want a simple plug-and-play implementation. During our implementation of Hinge Health, we appreciated Hinge Health’s flexibility and creativity in personalizing marketing communication for our employees based on formats and messaging that would best resonate. Hinge Health did a lot of the heavy lifting, including creating all the marketing materials to drive member enrollment. As a result, we met 100% enrollment goals very quickly.

We also appreciated the dedicated 1-on-1 physical therapists and health coaches who worked closely with our employees virtually, tailoring the Hinge Health program to their unique needs. For example, if an employee with MSK pain had comorbid conditions like depression or obesity, then a Hinge Health coach would develop a personalized care program addressing mental health issues or weight loss. We appreciated this more holistic approach to MSK care embedded in a person’s unique lifestyle.

Salesforce’s clinical and medical claims outcomes

We analyzed three years of medical claims starting in 2017 before Hinge Health and compared them to 2019 after we piloted Hinge Health. Here is a summary of our clinical and medical claims outcomes.

Overall, program engagement was high. Across our population, participants completed an average of 2.7 exercise therapy sessions a week, interacted with their health coach and physical therapist 5.2 times a week, and read 13.8 educational articles.

We believe that this successful engagement and adherence was achieved with the help of Hinge Health’s dedicated virtual one-on-one physical therapists and health coaches, who helped motivate participants to complete the program.

58% reduction in MSK pain

By participating in the program, 9 of 10 participants reported pain reduction. More specifically, participants experienced an average pain reduction of 58%. To put that into context, in clinical trials of opioids, the average pain reduction was 15%, so our members were seeing pain reduction that was about four times what they would have expected with opioids.

Hinge Health & Salesforce - 58% reduction in MSK pain

Not surprisingly, people who completed more exercise therapy sessions experienced greater pain reduction. This underscores the importance of member support. In today’s busy world, members with chronic conditions need support finding time for self-care. Hinge Health’s deep bench of clinical experts, including full-time in-house doctors of physical therapy and health coaches, were a game changer.

60% decrease in MSK medical claims over three-year period

When members’ pain decreases, we expected they would be less likely to pursue surgery, and that’s what we saw. After the 12-week intensive phase, participant interest in surgery declined and we avoided 2 of 3 surgeries.

So, how do these clinical outcomes translate into financial outcomes? We took a look at our three-year medical claims for members struggling with chronic back or knee pain.

For our baseline population, MSK claims were relatively flat. However, on the right of the chart, for our members with Hinge Health, MSK medical claims declined by 60% in the same time period.

Hinge Health & Salesforce -  60% decrease in MSK medical claims over three-year period

Mental health improved and medical claims declined by 55%

Participant mental health also improved. Research shows a strong connection between depression and chronic pain. Often, these two conditions are intertwined. The gray bars are the baseline percentage of members with either anxiety or depression. After 12 weeks, you can see that anxiety fell by 74% and depression declined by 48%.

Hinge Health & Salesforce - Mental health improved and medical claims declined by 55%

Again, we wanted to see how clinical outcomes translate into financial outcomes, and we looked at all our members with back or knee claims. For the group that did not participate with Hinge Health, our mental health claims grew 8%, but for participants with Hinge Health, we saw a 55% decline in mental health claims.

Hinge Health & Salesforce - Addressing Co-morbidities

Another area of savings is from increased productivity. When people are feeling better physically and mentally, we have a more engaged and productive workforce. Within the first three months, we saw a 62% decrease in absenteeism and presenteeism.

How one Salesforce employee reduce his MSK pain and avoided surgery

We’ve just covered a lot of stats, but ultimately, as benefits professionals, we are working toward improving the lives of our employees and their families. So, lastly, we wanted to share one of our participant success stories.

Before we offered Hinge Health, a 50-year-old program architect at Salesforce, a swimmer, relied heavily on pain medications to get through the day and had a 100% likelihood of having surgery in the next five years. Working with his Hinge Health physical therapist and health coach and completing his weekly exercises, he significantly reduced his pain and his likelihood of surgery. He said being pain free and living without pain meds boosted his confidence and enabled him to go back to doing the activities he loved, such as swimming.

Resolving comorbidities was a pleasant surprise

When we looked at our three-year medical claims analysis, we saw significant reductions in MSK pain and medical claims spend for the Hinge Health participants. But we were pleasantly surprised with how successful Hinge Health was at addressing comorbidities like depression and anxiety—even more critical now during the pandemic. Ultimately, our members were very satisfied with the program, rating it 8.7/10, and Hinge Health’s Digital MSK Clinic has continued to help resolve our members’ chronic back and joint pain from the comfort of their homes throughout the pandemic.

Find out how you can implement Hinge Health to reduce your members’ MSK pain and your MSK spend by requesting a demo below.

About the Author

Gina Hanrahan Bio: As the Director of North America Nenefits, Gina leads the strategy, design, and implementation of benefit programs for employees in the United States and Canada. Under the “Camp B-Well” brand, Gina is honored to support the 35,000 employees of Salesforce’s ohana in their health and wellness journeys as they forge ahead in all aspects of their lives. Before Salesforce, Gina was in benefits roles in a large national healthcare system and a leading pharmaceutical company, focusing on the design and administration of US health programs.

Grace Gaddi Bio: As the Senior Manager of Global Benefits, Experience, and Delivery, Grace plays a pivotal role in designing and implementing innovative benefits programs that improve the overall health outcomes and lives of Salesforce employees and their families. As a result, Grace has become a champion, changing the narrative of employee health at Salesforce. Before Salesforce, Grace was in benefits roles at other large tech firms, focusing on the strategy and design of employee health programs.

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