By Kim Dwyer
Vice President
Inspera Health

Highlights of members with 5 or more chronic conditions:

  • 50% are in the top 10% of the 3-year spend, and 90% are in the top 20% of the 3-year spend.
  • 33% of your workforce that are over the age of 50 have 5+ conditions.
  • On average, they are 52 years old with 12+ years of service – they are not career mobile.
  • 50% of this group has an extended absence event every year.
  • Each will cost your company nearly $1 million by the time they are eligible for Medicare.

There are very few places in today’s data-driven environment where a high-cost claim can hide. Yet, a population segment represents a significant current and long-term liability that is identifiable but remains invisible. Because this group is not defined for analysis, they are unidentified, and the liability remains unquantified, so they go unaddressed.

This group is easy to identify, and long-term future costs can be significantly reduced. Who is this group – health plan members with five or more simultaneous chronic conditions. You can identify today who will be in this high-cost group five years from now. It is the only segment of the high-cost claimants that can be identified and addressed with absolute predictability.

You have been paying for this invisible group for as long as you have offered health insurance. You must take a step to identify this subset of members to avoid paying the health and absence claims as a cost of doing business. Unidentified, they will remain under the radar of opportunity for cost savings and managing your trend.

Alternatively, you could identify this group and assess their cost impact on your current health plan. Inspera Health can help your data analytics team, broker, or consultant run the analysis; alternatively, we can provide this analysis without cost or commitment.

Inspera Health is the proven, guaranteed solution to address your high-cost claims with five or more chronic conditions. Validation Institute has approved the methodology used for measuring our participant’s health improvement.

Read Inspera Health validation report HERE.

Get ValidPoints

Sign up for ValidPoints, the complimentary monthly newsletter that offers the latest updates on:

A red line drawing of an archery target with an arrow in the center bullseye, symbolizing precision, goal achievement, and success.

The move toward high-performance and high-value healthcare

Icon depicting customer support and care with a stylized human figure embraced by a hand, set against a segmented circular backdrop.

In-depth analysis of the latest trends and solutions that improve heath outcomes, strengthen accountability, and cut costs

Icon of a seal with a checkmark, representing verified completion or approval, with a radiating effect, in red outline on a light background.

Actionable insights on how to drive better health outcomes at a far lower cost for your organization.

Icon of a badge with ribbons and a check mark, symbolizing achievement, accreditation, or quality assurance in a red outline.

Profiles in innovative solutions and organizations that are “walking the walk” when it comes to delivering better savings, outcomes, and more