Laserfiche WebLink
The results of this review reflect the following: <br />• The IRC population is an older average (38, Book of Business <br />34). <br />• The Total Paid'MPM is in line with Book of Business. <br />• Spouses have a higher Paid PMPM ($592.17) than employees <br />($511.91). <br />• High percentage (84%) of members use the medical plan with <br />favorable utilization patterns and great access to physicians. <br />• Increased urgent care and emergency room utilization, <br />especially primary care treatable/non-emergent, among <br />employees. <br />• Most treated conditions are hypertension, hyperlipidemia and <br />musculoskeletal, which could be treated in a clinic setting. <br />• 72% of ER visite occur Monday through Friday. <br />• High percentage (17%) of members have 3+ chronic conditions <br />which represen-s 45% of plan Total Paid. <br />• IRC is expected to use 31% more health care resources than the <br />Book of Business based upon population risk. <br />• Employees have conditions that can be most impacted with <br />interventions resulting in improved outcomes. <br />• Diabetes (7%), Pre -Diabetes (7%), musculoskeletal disorders <br />(43%) are the most experienced conditions and are more <br />prevalent than the Book of Business. <br />Demographics and Costs (PMPM is Per Member Per Month) <br />(Children Not Reported) <br />rrent Members <br />3,690 <br />1,690 <br />811 <br />erage Age <br />37.7 ................... <br />................... <br />33.9 48.8 <br />.................. <br />49.6 <br />tal Allowed <br />................... <br />.................. <br />.................. <br />count <br />$23,383,083 .... <br />$8,531,294 <br />$4,591,365 <br />id Total PMPM <br />5456.22 <br />$454.70 $511.91 <br />$592.17 <br />aid Medical <br />MPM $329.61 $343.99 $368.30 $406.31 <br />aid RX PMPM $126.61 $111.71 $143.62 $185.87 <br />• Aging population which suggests need for preventive care and condition management, <br />services that a wellness center can offer. <br />• Total Paid PMPM in line with the norm, with slight Paid RX PMPM surplus. <br />• Employees have conditions that can be most impacted with interventions resulting <br />improved outcomes. <br />• On paid perspective, spouses have significantly higher PMPM. Advance cost shifting <br />strategy by phasing spouses into clinic eligibility, over a multi-year period, to divert care <br />from the community to the clinic. <br />