Return on Investment for a Payer–Provider Partnership to Improve Care Management of Employees and Early Retirees

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Abstract

Objective:

A large employer partnered with local health care providers to pilot test an intensive nurse care manager program for employees and retirees. We evaluated its impact on health care utilization and costs.

Methods:

A database was developed containing 2011 to 2015 health care enrollment and claims data for 2914 patients linked to their nurse care manager data. We used a difference-in-difference design to compare health care costs and utilization of members recruited for the pilot program and a propensity-score-matched comparison group.

Results:

We found statistically significant reductions in doctors’ office visits and prescription drug costs. A return-on-investment analysis determined that the program saved $0.83 for every dollar spent over the 2-year pilot study period.

Conclusions:

Employer-driven care management programs can succeed at reducing utilization, although they may not achieve cost neutrality in the short run.

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