Benefits experts on evaluating and ensuring health program ROI
Is a point solution really worth your time, effort, and money? Leaders from Willis Towers Watson and Zurich North America explain how they assess benefits options
At the end of the day, ROI is not just one of the most important factors to consider when evaluating programs like ours—it’s perhaps the most important factor.
But it can be hard to nail down, especially when there’s no shortage of options and promises being made.
Roy Steiner, Hinge Health’s Director of Partnerships and Business Development, sat down with benefits leaders from Willis Towers Watson and Zurich North America at the second annual Movement conference to discuss hard and soft ROI, value on investment (VOI), the importance of supporting data (and what they look for), and more.
They were also joined by Dr. Jeffrey Krauss, MD, Hinge Health’s Chief Medical Officer, who shared how we work to deliver the information you need to feel confident in your partnership with us.
“The digital health market is in a much more mature place—and that has put a spotlight on ROI.”
Courtney Stubblefield Insights & Solutions Leader, Health and Benefits, North America, Willis Towers Watson
ROI and VOI measures are critical right now.
With the maturity of digital health, the adoption of all of the new innovation, and the current economic environment, employers and those who manage benefits for them are being called to the table to say whether these solutions are delivering the value that they intend to.
I think we are talking about measures around things like engagement, satisfaction, experience, and clinical metrics of value. And ultimately, what we are really seeking is a measurement of ROI: Whether a solution can help save an organization money and avoid costs.
“There’s no magic formula when it comes to ROI and VOI—and they are some of the toughest nuts to crack.”
Nate Soloman Vice President, Head of Benefits, Zurich North America
We don’t have it all figured out as an employer. It’s difficult to demonstrate why and how we are getting a return on investment.
But we have a lot of vendors and point solutions that we put in, and we have to assess whether each one is really worth our time, effort, and money to make sure that not only is the company getting value, but more importantly are the employees seeing value.
It’s really all about data. Are we slicing the data thin enough to get a good core sample to really measure and analyze.
We rely heavily on our partners at Willis Towers Watson, who we work closely with for health consulting. They help us analyze, study, and measure.
But there's no magic formula I can show you.
“We have noticed a decrease in our MSK claims since we started working with Hinge Health. Even though that’s still a high category for us, there is a correlated drop in expenses there, which is phenomenal. And that's really what we're aiming for.” —Nate Solomon, Zurich North America
“There is definitely an ROI waiting period that is sort of inevitable.”
Dr. Jeffrey Krauss, MD Chief Medical Officer, Hinge Health Board-certified physician, physical medicine, rehabilitation, and lifestyle medicine
At Hinge Health, we have a team of researchers, statisticians, and health economists who have been working on clinical outcomes studies and cost outcomes studies for a long time.
ROI is really hard. The main thing is that surgeries are rare, but they are very expensive. So we have to keep track of them, monitor them. But it takes a long time for them to show up in the claims data to see that there is actually savings. So there is definitely a waiting period with ROI that is sort of inevitable.
Over time, Hinge Health has added a lot of rigor into the analyses we do. In terms of specific metrics, overall cost savings and utilization are the two main buckets we look at.
Surgery is the big spend. So, a lot of our focus is on avoiding surgery. We are also looking at imaging, office visits, physical therapy visits, other kinds of procedures—there are lots of different areas within ROI to look at.
But that’s not all. Hear what Dr. Krauss considers leading indicators of a return on your investment that don’t show up as claims savings.
Did You Know?
Hinge Health has 10 clinical studies that are peer-reviewed and four medical claims analyses that have been reviewed by independent actuarial firms.
About 5% of health plan members make up about 85% of all MSK costs. Hinge Health uses a variety of data sources, algorithms, and machine learning to identify high-risk members so they can receive increased, early support in an effort to avoid future surgery.
“There needs to be transparency in the data.”
It’s important to have a data warehouse so that, ultimately, some type of standard evaluations can be established.
We are committed to doing that and work with organizations like Hinge Health to have transparency in the data and solid reporting, so we can get the measures we need and work toward establishing ROI.
There is also a lot of use for studies, but there is a proliferation of them.
High ROI raises red flags—it requires peeling things back and looking hard at the data.
There are a lot of people developing expertise pulling them apart and assessing the data.
I think we're evolving to a place where employers will be able to have, you know, clearer insight into what's going to drive value and how to achieve that.
Here, Courtney shares what she and colleagues at WTW look at when evaluating a study and helping employers evaluate benefits options:
We have had the opportunity to review some of Hinge Health’s studies, specifically some on the manufacturing and service industries. We found that methodology to be sound. -Courtney Stubblefield, Willis Towers Watson
“It’s not just about hard-dollar savings.”
Dr. Jeffrey Krauss, MD
Ultimately, you absolutely need to look at claim savings. But there are some other really important metrics that you also need to consider.
In addition to engagement and workplace productivity, look closer at:
Opioid use: Using opioids to manage pain brings the risk of addiction and all of the problems that come with that.
Mental health: We track depression and anxiety in our program. I think there’s a huge amount of benefit that can come from addressing these issues, even if there isn’t cost savings directly tied to them.
“Ultimately, making sure our employees are well taken care of is what we care about.”
We know that consolidating data and being able to see it across the medical and prescription drug benefits carriers is really crucial. That complete picture of total claims allows us to look at things through a lens that we didn't have previously.
Our partner WTW’s data warehouse pulls data from vendors, which is very helpful. For example, we held a vendor summit where we pulled in all of the partners who touch anything related to oncology.
We looked at case studies and the process they would follow: they get a diagnosis, who reaches out to them, what happens next, etc.
Solomon continued, detailing the outcomes of the summit and the next steps they followed to make sure their program investments were best serving employees and budgets:
Hinge Health member testimonials
“What may seem like a minimal improvement is really monumental,” Steiner said to the panel.
And it seems the employees at Zurich North America agree.
Here is some feedback he has received from Zurich North America employees participating in the Hinge Health program:
“I'm keeping at it. I am working with a personal trainer three to four times a week. I'm getting stronger. Hinge Health remains the single most valuable resource to make my back feel a little bit better in any given day.”
“My shoulder is doing so much better. While in bed, I reached over to place my phone in the charger with no pain. Before I started Hinge, that was painful. I would have to sit up to do this. I feel the difference. Thanks so much for all your encouragement and help through this process. You are very much appreciated.”
“While we don't have a lot of quantitative data on ROI, we do have qualitative data,” Solomon said of Zurich’s analyses. “When you hear something like that—it’s just a win-win for everybody.”