Point solutions up close: Case study in managing cost and driving engagement  

Point solutions promising cost savings and better employee outcomes have been entering the market at a fast clip for years now.  Not only do these solutions address a wide – and continually expanding – range of health issues, but different point solution vendors that address the same issue have found ways to differentiate their services.  All of this adds complexity for employer health plan sponsors.  When budgets are tight, it’s important to know that every investment is adding value. 

That’s why I recently reached out to my colleague Agnes Quiggle and asked her to spill the tea on what solutions are making the biggest impact. Agnes leads Mercer’s Health Transformation Collaborative, a 10-year collaboration with several mid-size employers looking for more effective cost management solutions for their medical and pharmacy benefits. The HTC brings together a range of digital solutions with proven health outcomes, focused on enhancing the member experience, improving quality of care and reducing costs in an integrated healthcare delivery platform. The group, which has grown over the years, meets quarterly to offer feedback and advice and periodically previews possible new vendors and resources for the collective. Importantly, it is a rich source of data and information on how a broad range of point solutions perform over time across a group of employers with different employee populations.  

Let’s cut right to the chase. What strategies or techniques have resulted in the biggest cost management impact for HTC member companies?  

HTC member companies have observed significant cost impacts in a number of areas. Diabetes management, musculoskeletal support, and complex care management are three important ones. 

For diabetes management, our vendor partner offers personalized care plans that include continuous glucose monitoring and tailored coaching from certified diabetes educators. The program leverages real-time data analytics to track patients’ glucose levels and health metrics, allowing for timely adjustments to their treatment plans. The program also offers 24/7 access to healthcare professionals so participants can receive support whenever they need it. HTC member companies achieved a 1.4-point reduction in HbA1c levels among members with uncontrolled diabetes. This reduction is significant because for every 1-point decrease in HbA1c, the risk of death decreases by 21%, the risk of heart attack drops by 14%, and the risk of peripheral vascular disease is reduced by 43%. One recent study found that, over three years, a 1.5-point reduction in HbA1c led to an average cost savings of $4,447 per member. 

To support members with musculoskeletal pain, a virtual physical therapy program combines personalized exercise therapy with digital health coaching. Users receive a tailored exercise plan delivered through a mobile app, which includes instructional videos, progress tracking, and access to licensed physical therapists for support and guidance. HTC member companies have seen a remarkable 44% reduction in the likelihood of surgery within the first year. This is a significant financial benefit, considering that knee or hip replacements can cost tens of thousands of dollars. The HTC members report a 3.5x return on investment for its musculoskeletal program, which has helped members alleviate pain, avoid expensive surgeries and become more productive. 

Complex care management is enhanced with health navigation and advocacy services.  This partnership with Mercer Health Advantage has yielded impressive results for HTC members. One employer reported an ROI of 5.5:1, translating to savings of $58.24 per employee per month, thanks to high-risk members engaging with a nurse navigator. MHA nurses specialize in supporting high-risk, complex patients by coordinating and closing gaps in care.  

How about the employee experience?  What types of programs have had the most — or the most positive — plan member engagement?

We have witnessed remarkable engagement in behavioral health support among our members. Over the past few years, many workplaces have reduced stigma around accessing behavioral health support. They’ve fostered a more supportive workplace culture that prioritizes mental health, offers training for managers to recognize and address behavioral health issues, and helps employees to feel safe in seeking help. HTC employers have launched campaigns to raise awareness of available resources and even offered incentives to encourage employees to use them. Across the HTC book of business, more than half of employees are enrolling in and actively participating in some form of behavioral health care. Among those engaged, an impressive 88% are utilizing 1:1 text-based coaching and accessing self-care resources, such as on-demand guided content like meditation to help members stress less, sleep easier, focus and feel calmer.  

Cancer is one of the conditions that employers are most focused on.  How is the HTC addressing this critical area?

The constant feedback we receive from HTC members is essential to its success. Our highly engaged members identified cancer support as a priority last year and we began the process to find the ideal partner. During our search, the member workgroup discovered that many top-tier vendors in the cancer support space also provide Surgical Centers of Excellence. Surgical Centers of Excellence have many benefits for employers, including improved quality of care through access to specialized facilities and experienced surgeons, which can lead to better patient outcomes, and cost management with pre-negotiated surgical bundles that are below market price. Surgical Centers of Excellence also have benefits for employees, including efficiency in scheduling and white-glove service at COE locations.  

Last question: How are employers in the HTC taking advantage of new technology?

AI is already having a positive impact, especially in the HR realm. The demands on HR have increased over the year as workplace benefits and policies become more complicated. HTC members now have access to a solution that offers an AI agent to provide personalized support to employees with questions about benefits, leave, compensation, training and more. The AI agent allows HR to focus on functional excellence instead of backlogged individual inquiries. 

Given that the near-term outlook is for health benefit cost growth above 5%, we thought employer plan sponsors would be interested to learn about the types of vendor solutions that are delivering real results for HTC members. The combination of better cost management and increased engagement are two great metrics for program success – but it’s important to note that a multi-year commitment is essential for optimal results.  As you think about planning for 2026 and beyond, keep in mind that your strategy needs to be based on your population, and that analyzing plan data will help you pinpoint opportunity areas for the greatest impact.