Client Case Study

Large Case Management (LCM) and Disease Management (DM)

$8.5 million saved

  • Profile: Large Entertainment Corporation
    • 60,000 global employees
    • $300 million annual claims costs
    • 20,000 beneficiaries in DM program (12,000 expected)
    • Funding Type: Self-Funded
  • Challenges
    • No ROI on current large case claims management
    • Patients’ health declined with participation DM program
    • Current DM vendor grossly overestimated “savings” estimates
  • Strategy
    • Evaluate current and prior-year large claims by cost and diagnosis
    • Profile current and projected burden of illness from diagnoses, including diabetes, heart disease, lung disease, asthma, high-risk maternity, etc.
    • Project impact of best-in-class disease management results
    • Project potential savings and impact of enhanced services
    • Report on hard-dollar savings and ROI
    • Recommend steps to achieve savings and program improvement
  • Results
    • Improved clinical outcomes
    • 12-month results: 6:1 ROI- $8.5 million saved
    • 24-month result projection: 8:1 ROI - $10 million saved
    • $1.5 million saved in annual fees