#1: We engage ~50% of employees to routinely use Sherpaa
#2: We get ahead of issues before expensive care happens in-person
#3: We solve 70% of cases without in-person claims
#4: We care coordinate cost-effective in-person care for the other 30%
#5: It only takes preventing a few high cost cases to significantly alter costs
An employee went to the ER and was diagnosed with a mild pneumonia, treated with one dose of IV antibiotics, and sent home after 5 hours on oral antibiotics. The bill was ~$12,000. With the $150 co-pay, the full contribution toward the $1,500 deductible, and the $1,300 co-insurance payment, the employee spent $1,950 out of pocket. The employer was then responsible for the remaining $10,050 of the bill plus the full cost of the rest of the year’s bills for that employee. This is a very common diagnosis and a very common situation to use the ER.
Here’s how Sherpaa would have handled this:
The employee fires up Sherpaa's app and explains the situation. We ask questions that lead us to suspect a potential pneumonia. Based on our suspicion, we send the employee to get a chest X-ray at a local imaging center, get the results, and prescribe an antibiotic through the app. His out-of-pocket spend would be $100 for the x-ray and then $20 for the oral antibiotics. We then follow up on a daily basis with the employee to see that everything is resolving as expected.
Total cost for this episode: $270 ($150 paid by the employer or employee + $120 for the X-ray and medication paid by the employee).
A $150 Sherpaa visit paid by the employer saved the employer $10,050 and the employee $1,950.
For the last 5 years, Sherpaa has consistently found that 70% of all cases created by employees can be diagnosed and treated virtually. And for the other 30%, if you carefully coordinate care with local specialists and facilities, you can cost-effectively get them the most appropriate care. Cases can be simple like antibiotics for a UTI, moderate like a pneumonia, or complex like coordinating care with local specialists for a newly diagnosed cancer.
After analyzing the data from ~10,000 Sherpaa cases, every 1000 cases prevents:
280 primary care visits at a cost of ~$175
350 urgent care center visits at a cost of ~$350
70 ER visits at a cost of ~$2,000
Here's how your employees spend on healthcare:
How does offering your employees in-house, convenient first-dollar care save on the total cost of care?
- For the Super-Healthers, the 50% of people that spend $200 or less per year, Sherpaa doesn’t impact costs. It’s a convenient benefit they’ll use once a year. This is also where traditional video visit companies like Teladoc play. Short, quick transactions can only diagnose and treat simple things. Pink eyes don't move the needle.
- For the Utilizers, the 40% of people who spend ~$5,000 or less per year, Sherpaa will reduce the number of employees who spend their entire deductible. Usage/engagement is key in this group. We typically see ~50% of these employees using Sherpaa. This is where Sherpaa focuses and shines. Because Sherpaa orders tests and the same doctors manage moderate and complex issues over time, just like a traditional PCP, we significantly impact claims and costs in this group.
- For the Hyper-users, the 10% of people who spend 65% of costs, Sherpaa organizes their care and prevents some unnecessary usage. Again, usage and engagement is key and also where Sherpaa focuses. But honestly, this is also the most difficult given that most of this care happens inside the walls of hospitals.