In most health insurance programs, a small percentage of the plan members account for a significant percentage of the claim payments. In the past, employers focused on population health management or wellness programs to improve the overall health of their employees and their families with the goal of lowering costs.
Although wellness programs can be an effective tool to identify and manage health risks, the cost and time to implement them does not always lead to savings.
Enter precision medicine. Medicine has evolved to enable treatment to be tailored to each person by considering differences in specific characteristics of individuals such as a person’s genetic makeup, environment and lifestyle. The goal is to target the right treatments to the right patients at the right time. It is not the one-size-fits-all approach of the past.
We now use claims data to better understand the medical conditions of a group so we can identify those individuals driving the cost. And it can even save lives.
Here are a few examples of how precision medicine turns the tide.
The personalized approach focuses on reversing diseases such as autoimmune disorders. Rather than controlling a condition, the goal is to eliminate it or drastically reduce symptoms, so the patient needs less health care.
Pharmacogenetic testing can determine how an individual’s body will react to drugs and treatments. Doctors study how genes affect a person’s response to certain drugs and combine pharmacology (the science of drugs) and genomics (the study of genes and their functions) to develop effective, safe medications and doses that are tailored to a specific person.
A new test can screen for more than 50 cancers with a simple blood draw. It could detect signs of cancer before any symptoms are present, enabling the patient to begin treatment early, which is proven to lead to better outcomes.
Science has also evolved to avoid up to 70% of orthopedic surgeries by using the body’s natural healing agents. Stem cells and blood platelets are concentrated in a lab and injected under image guidance into the precise area of an injury without invasive surgery and lengthy recovery.
In short, we can identify those few individuals with specific conditions who are incurring significant claims and address them in a different way.
Contact us to learn how the experts at Oswald can work with insurance carriers and the medical community to provide better, more targeted treatment for your employees.
Note: This communication is for informational purposes only. Although every reasonable effort is made to present current and accurate information, ISBC makes no guarantees of any kind and cannot be held liable for any outdated or incorrect information.