Cost-Effectiveness Analysis Is Necessary To Determine Cost Savings
CareScientific uses the science of cost-effectiveness analysis to determine the real net savings opportunity by looking at the full costs and benefits of each intervention based on evidence from randomized clinical trials and epidemiological data. Using cost-effectiveness assessment, CareScientific can accurately distinguish between those activities that, while clinically appropriate, do not save money and those that provide real cost savings.

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Care Management with an Emphasis on Medication Use
Medications Are Key To Cost Savings, But Only When Targeted Correctly
Cost-effectiveness analysis shows that initiation and adherence to pharmaceutical therapy for selected patients and medications is one of the greatest opportunities for short-term savings for chronic conditions. However, increasing compliance for some patients only increases drug costs without the commensurate decrease in medical costs. To select only the patients with real net saving opportunities, CareScientific developed Cost-Effectiveness Filtering™, a proprietary algorithm based on an extensive quantitative review of control-group cost-effectiveness assessments that identifies only the patient and health behaviors that can yield real cost savings.

Savings Are Quantifiable and Incremental to Existing Programs
Reason being, disease management programs do not sufficiently focus on or, as evidenced by the latest research, improve medication compliance.4

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Real Savings You Can Verify
The determination of actual savings from care management programs can be challenging due to the various secular trends that can cause cost changes and the potential for regression to the mean. CareScientific takes the most rigorous approach to establishing a causal link between our program and outcomes based on the following evaluation components:

• Use of a comparison group consisting of similarly diseased members who are not eligible for the program— to control for other factors that could cause the change
  
• Plausibility assessment that looks for changes in the expected direction and amount for various intermediate outcomes and cost components—to provide confidence that the savings are due to the program
• Transparency in savings opportunity, methodology and outcomes -- to provide plan sponsors the ability to verify the results

Accordingly, CareScientific is advancing new standards for outcomes measurement and reporting through rigorous, control-group methodology, plausibility assessment, and transparency to provide outcomes that are accurate and verifiable.

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Custom Program Evaluation
CareScientific’s researchers each have over a decade of experience in healthcare program evaluation, having conducted more than 100 custom analyses and receiving several research awards from scientific and professional organizations. We conduct independent and rigorous assessments of disease management (DM), wellness programs, value-based insurance design (VBID), and medication therapy management (MTM).

Using comprehensive plan data and proven evaluation methodologies, CareScientific helps plan sponsors determine the real outcomes from their healthcare programs, including:

• Financial outcomes, including ROI
• Clinical outcomes
• Humanistic outcomes, such as quality-of-life
• Member satisfaction and provider satisfaction
• Processes of care and other leading indicators that are necessary steps to outcomes improvement
  

Frequently, CareScientific employs comparison groups to determine what outcomes improvements are due to the program rather than to other market trends. We also conduct plausibility assessments of programs to determine whether the vendor-claimed ROI is plausible given the nexus of changes in outcomes and leading indicators.

See the Awards and Research section for examples of CareScientific’s previous evaluations.

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