We work with over 300 employers, healthcare providers, associations and health plans

Client Success Stories

We work with over 300 employers, healthcare providers, associations and health plans

Client Success Stories

“HCMS has been instrumental in the turnaround of the C&MA’s self-funded health plan. Their ability to bring data, analytics and clinical services together was key for us - and something we hadn’t seen in the market. The clinical intervention service of KnovaSolutions and the predictive modeling HCMS developed to identify those in need helped improve the experience of our members with complex health issues.”


Ken Baldes

Vice President & Treasurer,
C&MA

Read the C&MA Case Study

“Our partnership with HCMS is an opportunity for us to improve the health of our population and control our healthcare costs in a very targeted manner. I rely on HCMS to interpret the data and identify our top 5% spenders, and then directly contact those people to engage them in making better choices for their healthcare.”


David Barnes

Manager of Compensation & Benefits,
Lacks Enterprises

Read the Lacks Case Study


Selected Clients

BENEFITS REDESIGN SAVES $5 MILLION PER YEAR

A population risk analysis for a large financial services institution indicated a higher-than-average rate of bariatric surgeries. Further analysis showed that many of the bariatric surgeries were tied to employees who had joined the company, worked six months to become eligible for benefits, had the surgery, and almost immediately left the company. Due to the company’s rich coverage, they had become the bariatric surgery “employer of choice” in the region and were attracting employees who were not necessarily interested in employment, but rather the benefit of the bariatric surgery.


Given the points above, the company was motivated to reduce utilization for bariatric surgeries, but didn’t want to discontinue this coverage altogether for any long-standing employees who would benefit from the surgery. As a result, the company continued to cover the bariatric surgery procedure, but instituted a longer qualification period to become eligible. The cost share for the surgery also increased and candidates were required to progress through a weight management program prior to the surgery.


The company now has approximate savings of $5 million per year due to fewer surgeries and a corresponding reduction in associated short-term disability claims.

BENEFITS REDESIGN SAVES $5 MILLION PER YEAR

A population risk analysis for a large financial services institution indicated a higher-than-average rate of bariatric surgeries. Further analysis showed that many of the bariatric surgeries were tied to employees who had joined the company, worked six months to become eligible for benefits, had the surgery, and almost immediately left the company. Due to the company’s rich coverage, they had become the bariatric surgery “employer of choice” in the region and were attracting employees who were not necessarily interested in employment, but rather the benefit of the bariatric surgery.


Given the points above, the company was motivated to reduce utilization for bariatric surgeries, but didn’t want to discontinue this coverage altogether for any long-standing employees who would benefit from the surgery. As a result, the company continued to cover the bariatric surgery procedure, but instituted a longer qualification period to become eligible. The cost share for the surgery also increased and candidates were required to progress through a weight management program prior to the surgery.


The company now has approximate savings of $5 million per year due to fewer surgeries and a corresponding reduction in associated short-term disability claims.

INDIVIDUAL BENEFIT COSTS REDUCTION OF 67%

A male member enrolled in KnovaSolutions with an annual health benefit cost of $18,953. He was seeing 25 specialists and had been diagnosed with 19 health conditions including hypertension, hyperthyroidism, and nerve pain. He was taking 13 medications and had a Human Capital Risk Index® (HUI®) score of 2.95, almost 3 times riskier than average.


The member met with his KnovaSolutions® clinical prevention team which consists of a nurse, pharmacist, and medical research librarian. He had thirteen meetings with his team to receive decision support on health preservation and utilization.


He is now seeing 1 primary care provider to coordinate his care. He has limited his specialty care providers by more than 50%. He has been able to eliminate three medications and now has a HUI risk score of 2.05. His annual integrated benefit costs now total $6,270, a 67% reduction from initial enrollment in the service. The member continues to receive decision support and education from his KnovaSolutions team.

INDIVIDUAL BENEFIT COSTS REDUCTION OF 67%

A male member enrolled in KnovaSolutions with an annual health benefit cost of $18,953. He was seeing 25 specialists and had been diagnosed with 19 health conditions including hypertension, hyperthyroidism, and nerve pain. He was taking 13 medications and had a Human Capital Risk Index® (HUI®) score of 2.95, almost 3 times riskier than average.


The member met with his KnovaSolutions® clinical prevention team which consists of a nurse, pharmacist, and medical research librarian. He had thirteen meetings with his team to receive decision support on health preservation and utilization.


He is now seeing 1 primary care provider to coordinate his care. He has limited his specialty care providers by more than 50%. He has been able to eliminate three medications and now has a HUI risk score of 2.05. His annual integrated benefit costs now total $6,270, a 67% reduction from initial enrollment in the service. The member continues to receive decision support and education from his KnovaSolutions team.

RESEARCH SUPPORTS EARLY DISEASE DETECTION

RESEARCH SUPPORTS EARLY DISEASE DETECTION


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