3 Myths Holding Benefits Teams Back from Adopting Digital Therapeutics

Tom Kahl, CRO

Despite demonstrated clinical and financial advantages, some organizations have not yet adopted digital therapeutics. In many cases, it is not an issue of competing priorities, but rather it’s an issue of myths and misconceptions. 

There are three common myths that keep some organizations — including self-insured employers whose claims costs are expected to climb 5.2 percent in 2022 --from reaping the rewards of digital therapeutics. The good news is that debunking these myths is fast and easy.

Myth 1: Digital therapeutics are expensive

Fact: The cost-to-value of a digital therapeutic that focuses on promoting heart health can potentially save self-insured employers millions in medical claims by reducing spending on avoidable invasive procedures, treatments, and diagnostics.

For example, cardiovascular disease is the most expensive chronic condition in the U.S. with an overall price tag of about $363 billion each year. And not surprisingly, cardiovascular disease is among the top (if not number one) driver of claims costs for many self-insured employers. 

Indeed, according to an independent analysis of 2017-2020 employer claims data that was commissioned by Hello Heart, the average total medical spending per year for each individual with hypertension is $9,842. But could some of these costly claims have been avoided? In many cases, the answer is yes.   

Source: How Digital Care is Reducing Employer Cardiovascular Spend

High blood pressure, or hypertension, is one of the leading risk factors for development of cardiovascular disease and stroke. Early detection and management of high BP can be key to catching risk in time and intervening before more serious issues develop. Untreated hypertension can come at a high price, including undergoing costly invasive procedures that otherwise could have been avoided.

A digital therapeutic solution that helps employees track and improve their heart health may not only lead to behavior change resulting in lower blood pressure (and subsequent lower risk of cardiovascular disease, stroke, and other conditions), but it may also reduce claims costs. The analysis found that Hello Heart’s coaching app saved an average of $1,865 in total year one medical costs per participant compared to matched non-participants.1

A separate 2021 analysis of Hello Heart’s book of business found that employers who offer Hello Heart’s coaching app saw a minimum 2:1 return-on-investment.2

As for the budgeting concern, many organizations have excess wellness funds. Yet benefits leaders may not know that these funds can be used to pay for this type of solution. In some cases, digital therapeutics may also be able to be billed through an organization’s health plan as a preventative benefit.

Myth 2: Implementing digital therapeutics is difficult

Fact: It is true that some vendors place the burden on benefits teams to implement a new solution, and figure out how digital therapeutics fits into their ecosystem. This can be tedious, costly, and risky. But there is another truth to consider: not all digital therapeutics partners are created equal.

In addition to demonstrating clinical impact and cost savings, leading vendors will: 

  • Have a proven track record of success and be able to provide testimonials and case studies from similar industries and populations.
  • Handle all of the implementation and roll-out “heavy lifting,” including enrollment marketing and billing set up.
  • Have a simplified contracting, billing, and referral process—with strong relationships and deep integrations with health plans, PBMs, and other ecosystem partners.
  • Provide a strategic communication plan, and dedicate resources to accelerate employee adoption and engagement.

Another important consideration is timing of implementation. Open enrollment is one of the most stressful times of the year for benefit leaders. Due to the efficiencies mentioned above, they can easily launch a new digital therapeutic benefit solution off-cycle – during a vastly less stressful and hectic time. A vendor can help strategically plan off-cycle implementations that maximize target population enrollment. For example, Hello Heart often partners with clients to launch during a health awareness month such as American Heart Month in February, and National Cholesterol Education Month in September, when heart health is top of mind.

You can plug Hello Heart into your existing ecosystem off-cycle.

Essentially, leading vendors do not just “sell” a digital therapeutics solution. They lean forward and ensure that organizations have a positive implementation experience — because that lays the foundation for rapid adoption. 

Myth 3: Most employees won't utilize a digital therapeutics benefit.

Fact: It’s a frustrating and all-too-common story: the benefits team just rolled out a promising new program, but many employees do not sign up. And several of those who do, fail to use it. However, there are practical ways for organizations to avoid these pitfalls, and instead drive enthusiasm, adoption, and ROI. Here are a few tips.

  • Do not take a one-size-fits-all approach to delivering benefits. Instead, choose digital therapeutic solutions that deliver targeted benefits for different segments of the workforce based on their needs. 
  • Roll out a multi-channel communication strategy that drives employee awareness and enthusiasm. The vendor should play a key role here by providing resources, sending out mailers and emails, and running on-site/online enrollment events.
  • Once employees have enrolled, keep them engaged so that they use the benefit and start seeing results. Effective engagement strategies may include: built-in gamification that makes solutions “sticky” and fun to use, exceptional user support and customer service, and targeted campaigns during health awareness months. Again, the vendor is a key driver here.

The Bottom Line  

Digital therapeutics may provide employees with a convenient, engaging, and effective way to manage and control their health. They may also enable organizations to sustainably, strategically, and significantly reduce medical claims costs. Digital therapeutics are not just altering the benefits landscape. In some ways, they are re-inventing it — which is a major win for employees and organizations alike.

Footnotes:

1: Validation Institute. 2021 Validation Report (Valid Through October 2022). https://validationinstitute.com/wp-content/uploads/2021/10/Hello_Heart-Savings-2021-Final.pdf. Published October 2021. Accessed [2/15/2022]. (This analysis was commissioned by Hello Heart, which provided a summary report of self-funded employer client medical claims data for 203 Hello Heart users and 200 non-users from 2017-2020. Findings have not been subjected to peer review.)

2: Depends on employer size. Based on data on file at Hello Heart.