Alliance Data Case Study
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Transcript of Alliance Data Case Study
Healthcare in your hands. Learn how Alliance Data took control bending the health care cost curve.
Alliance Data saved
in just
by taking healthcare into their own hands.
$ 407,820
12 months
1. Alliance Data Overview2. Nationwide Epidemic: Widespread lack
of access to healthcare for low acuity medical conditions
3. The Problem: Alliance Data Sees Higher Utilization of Emergency Room on Their Claims
4. The Solution: MDLIVE5. Implementing the Solution6. Employee Response7. Hitting the Bottom Line
O U T L I N E
Alliance Data Systems Corporation
is a publicly traded company basedin Plano, TX that provides customerloyalty solutions, such as privatelylabeled credit cards, and otherdirect marketing services derivedfrom the capture and analysis oftransaction-rich data.1
“Our streak continues. First added to the S&P500 and now making Fortune’s list of theWorld’s Most Admired Companies. It’s atremendous source of pride to be named oneof the world’s most valuable companies.2
Ed HeffernanAlliance Data
President & CEO
W h o i s A l l i a n c e D a t a ?
1 . A l l i a n c e D a t a O v e r v i e w
1. http://en.wikipedia.org/wiki/Alliance_Data2. http://alliancedata.com/
2. The Nationwide Epidemic:
Widespread lack of accessto healthcare for low acuity medical conditions.
T h e N a t i o n w i d e E p i d e m i c
A f f o r d a b l e C a r e A c t e x p a n d s c o v e r a g e , b u t s t r e t c h e s p r o v i d e r s t h i n .
The Affordable Care Act has:
+Increased demand for health care, particularly in underserved rural areas, creating higher demand for physicians 2
+
Incentivized re-direction of low acuity care, by changing the way we pay providers from fee-for-service medicine (where they are paid based on volume) to reimbursement based on the quality of care they provide. 3
+
Penalized hospital re-admission. Return trips to the hospital costs Medicare 17 billion each year, to say nothing of the difficulties for the patients themselves.4
1. “Saving U.S. Health Care With Skype | Time.com." Swampland. Time Magazine, 16 Sept. 2013. 2. http://www.aafp.org/news/practice-professional-issues/20140205rgctelemedicineforum.html3. http://www.forbes.com/sites/brucejapsen/2013/12/22/obamacare-doctor-shortage-to-spur-2-billion-telehealth-market/4. http://www.cms.gov/apps/docs/innovations_for_better_health_and_stronger_medicare.pdf
“There is this perfect storm of increased demand with the newly insured, a shortage of primary-care physicians and specialists, and a
need to keep costs in control. I think telehealthprovides a real vehicle for doing that.”1
Mario GutierrezExecutive Director of the
Center for Connected Health Policy
TIME Magazine
Lack of access lead Alliance Data to see higher than expected Emergency Room utilization in their claims data.
3. The Problem
T h e P r o b l e m
Without affordable healthcare alternatives,employees often turn to expensive care forvery minor ailments.
Primary Care Doctor1
$ 104
Urgent Care Clinic2
$ 155
Emergency Room3
$ 570
L a c k o f a c c e s s l e a d s t o h i g h e r c o s t s .
1. http://www.debt.org/medical/doctor-visit-costs/2. http://www.debt.org/medical/emergency-room-urgent-care-costs/3. http://www.debt.org/medical/emergency-room-urgent-care-costs/
4. The Solution:
T h e S o l u t i o n
Te l e h e a l t h : H o w d o e s i t w o r k ?
1. Call MDLIVE
A patient calls a toll-free hotline that’s available 24/7/365.
3. Speak with an MDLIVE Doctor
Patient speaks over phone with a Board Certified doctor licensed in their state, just like an in-person visit. Our doctors can diagnose the patient, prescribe medication, and send prescriptions to the patient’s pharmacy.
PHONE:
2. Speak with a Care Coordinator
A health care coordinator evaluates the patient to determine if telehealth is appropriate, collects medical history and redirects the patient to a doctor.
VIDEO CONFERENCE:
1. Visit Website or App
Customer visit our website or mobile app, create a free account and complete their medical history.
2. Choose an MDLIVE Doctor
The patient can search for a doctor using criteria such as specialty, language, gender, location and can either make an appointment for a later time or speak now to the doctor on call!
3. See an MDLIVE Doctor Online
Once an available doctor is located, our system automatically connects the doctor to the customer via secure video conference.
T h e S o l u t i o n
M D L I V E : T h e c l e a r c h o i c e .
With a state-of-the-art health service center, MDLIVE offers 24/7 access to multi-lingual medical technicians.
Cloud-based video telephony eliminates new infrastructure or video servers while offering instant messaging and streaming video on a peer-to-peer basis.
Designed for individuals with chronic conditions, MDLIVE makes it easier for employees to manage their health.
67%
70%
69%
53%
MDLIVE’s Net Promoter Score comparable to:
T h e S o l u t i o n
W h o a r e o u r p h y s i c i a n s ?
*6% unresolved: 2% Out of Scope for Telehealth, 2% Seeking Medication Only, 1% Referred Elsewhere, 1% Sent to the ER
State Licensed, Board Certified, and credentialed physicians
Average 15 years of practice experience
Specialized training in communication and diagnosing patients over the phone and through online video
With more than 2,300 board-certified physicians and licensed therapist, MDLIVE offers the largest provider network.
MDLIVE offers a flexible platform that allows for sharing of data acquisition among different health systems with distinct EMRs.
Patient Medical Issues Resolved*
94%MDLIVE physicians adhere to highest quality standards and NCQA and URAC guidelines
(NCQA Certification Complete Q3 2014*)
5 . I m p l e m e n t i n g t h e S o l u t i o n
M D L I V E w a s i m p l e m e n t e d w i t h a c o m p l e t e c o r p o r a t e b u y - i n f r o m A l l i a n c e D a t a .
I m p l e m e n t i n g t h e S o l u t i o n
A c t i v a t i n g e m p l o y e e s p r o v i d e s t h e m w i t h a c o n v e n i e n t a n d a f f o r d a b l e a l t e r n a t i v e .
Alliance Data found that encouraging
employees to activate their accounts sparked a surge in consults and
utilization.
P r o g r a m S u c c e s s w a s d i r e c t l y a t t r i b u t a b l e t o s t r o n g c o m m u n i c a t i o n o f t h e b e n e f i t .
I m p l e m e n t i n g t h e S o l u t i o n
W h a t d i d A l l i a n c e D a t a e m p l o y e e s t h i n k o f M D L I V E ?
Excellent - 78%
Good - 14%
Fair - 3.5%
Unsatisfied - 4.5%
How would you rate yourexperience with MDLIVE?
6. The Employee Response
“Very easy to navigate and user friendly. It was wonderful and I was impressed with the quick response and simplicity.”- M e m b e r, C o l o r a d o
“Service is unbelievable! Very pleased with the service. The doctor was on the line in 10 minutes and it is great!- M e m b e r, C o l o r a d o
“The portal is very user friendly and overall the service is pleasant. It prevented me from going to the urgent care and was very convenient.” - M e m b e r, O h i o
W h a t k i n d o f c a r e d i d A l l i a n c e D a t a e m p l o y e e s n e e d ?
Top 5 Diagnosis:
1. Acute Sinusitis Unspecified
2. Acute Bronchitis
3. Acute Pharyngitis
4. Acute Upper Respiratory
5. Urinary Tract Infection
The Employee Response
Top 5 Prescriptions:
1. Amoxicillin
2. Zithromax Z-Pak
3. Tessalon Perle
4. Prednisone
5. Augmentin
Primary Care Physician Emergency Room Urgent Care No Treatment
7. H i tt ing the Bottom L ine
Primary Care Doctor 50.9%
Urgent Care Clinic 27.9%
Emergency Room 14.4%
No Treatment 6.59%
W h e r e w o u l d 1 , 1 5 2 p a t i e n t s h a v e g o n e i f M D L I V E w a s n o t a v a i l a b l e ?
Hitt ing the Bottom L ine
H o w m u c h t i m e w o u l d A l l i a n c e D a t a e m p l o y e e s h a v e s p e n t a w a y f r o m w o r k ?
Call and make appointment
Wait… Wait…Go to doctor’s office
See a doctor Pay Go to pharmacy
Standard Office Visit: Four Hours
𝟒 𝒉𝒐𝒖𝒓𝒔 × 𝟖𝟒𝟎 𝒆𝒎𝒑𝒍𝒐𝒚𝒆𝒆 𝒄𝒐𝒏𝒔𝒖𝒍𝒕𝒔 = 3,360 Hours
W h a t w o u l d t h a t h a v e c o s t ?
Primary Care Doctor: (587) $104 $61,048
Urgent Care Clinic: (322) $155 $49,910
Emergency Room: (167) $570 $95,190
Total Re-Direction Savings: $206,148
Estimated Productivity Savings: $181,440Based on 4 hours of work and a 3 times productivity multiplier
𝟒 × 𝟑 × $𝟏𝟖 𝒑𝒆𝒓 𝒉𝒐𝒖𝒓 × 𝟖𝟒𝟎 𝒆𝒎𝒑𝒍𝒐𝒚𝒆𝒆 𝒄𝒐𝒏𝒔𝒖𝒍𝒕𝒔
Gross Savings: $387,588Pilot Program $𝟎. 𝟖𝟓 × 𝟒, 𝟏𝟒𝟓 × 𝟖𝒎𝒐𝒔. + Full Program $𝟎. 𝟕𝟓 × 𝟏𝟏, 𝟔𝟐𝟔 × 𝟒𝒎𝒐𝒔. =
Consult Fees $𝟐𝟖 × 𝟏, 𝟏𝟓𝟐 𝒕𝒐𝒕𝒂𝒍 𝒄𝒐𝒏𝒔𝒖𝒍𝒕𝒔 = $63,064$32,256
Actual 12 Month ASO Fees: $95,320
Return On Investment: 4.07 : 1
Hitt ing the Bottom L ine