Quantum Health

Latest Actuarial Review Validates Significant Savings For Quantum Health Clients

Quantum Health, today releases third-party validation of its results, conducted by one of the largest actuarial firms in the world. This marks the ninth consecutive year the company has submitted results from its book of business for independent actuarial review.

The independent actuarial firm analyzed annual claims and membership for 118 Quantum Health clients comprising over 400,000 members between the years 2001 and 2016. Each year's book of business trend is compared to industry trend benchmarks to determine Quantum Health's impact. The book of business trend is the member-weighted average across all clients, after adjusting for changes in plan design, population demographics, plan migration and provider network.

In their actuarial opinion letter, the firm validated an average cost reduction of 5.0% from the market trends for Quantum Health clients in the initial year. Over the first 3 years, with Quantum Health, clients realized a cumulative average savings of 12.5%, with an average Compound Annual Growth Rate CAGR of 1.9%, compared to the industry average of 6.5% for the same time period.

In addition to analyzing historical groups from 2001 to 2016, the actuarial firm analyzed claims data for Quantum Health clients implemented between 2012 and 2016. They concluded that although there have been significant changes in healthcare benefit plan designs and delivery over the past 16 years, and market cost trends are much lower than in the past, Quantum Health clients experienced the same magnitude of financial results, with a -0.4% trend in year 1, and a much flatter 3-year trend, resulting in 11.9% savings through the third year, when compared to an industry average trend benchmark based on published trend results from AonHewitt, Mercer, S&P, Segal and WillisTowersWatson.

The two analyses suggest that the results Quantum Health has achieved are sustainable, repeatable and consistent across industries, benefit plan structures and demographics year after year.

"Submitting our results for actuarial review annually enables us to verify our ongoing effectiveness at creating a meaningful shift in cost," says Founder and CEO Kara Trott.

She attributes the company's long run of success to a deep understanding of the consumer's healthcare journey. "We applied principles of consumer research in retail, consumer goods and service industries to develop our model and have continuously optimized what we do based on nearly two decades of experience guiding our members and assisting their providers through the healthcare journey. It is our close connection to consumers and their providers that enables us to not only reduce cost but also deliver an exceptional healthcare experience that consistently earns Net Promoter Scores well above the industry average."

Net Promoter Score measures consumers' overall satisfaction and willingness to recommend a company's products or services. Quantum Health currently has a member Net Promoter Score of 73, which is above some of America's best-loved consumer brands and is approximately 55 points higher than the healthcare insurance industry average.

Quantum Health conducted additional studies to explain the reasons for the company's effectiveness in reducing cost trend. Engagement with members and their providers earlier and more often is critical. Overall, Quantum Health demonstrated engagement with 61% of the entire population, 95% of people with claims over $10,000 and 98% of people with claims exceeding $50,000. Provider interaction and collaboration is vital in driving cost savings—nearly 50% of contacts regarding a member's care were with providers. Quantum Health reports engaging with members and their providers who had claims over $10,000 up to 60 days before their claims reached $1,000. Earlier engagement with members and providers through what the company calls Real-Time Intercept™ positively impacts the claims trajectory and improves overall member experience.

The data indicated significant pre-post changes in utilization across the entire population, such as a reduction of inpatient admissions of 4.8% and a reduction of inpatient days by 12.5% in year one and 8.9% and 14.5% by year two, respectively. Primary care visits and the percentage of members utilizing preventive care services increased by 7.1% and 14.2% respectively.

Quantum Health Chief Operating Officer Shannon Skaggs says the company is very pleased with the results. "Even with our rapid growth, our approach to navigation continues to deliver a consistent, validated financial impact. Every year, we look at these reviews to evaluate the performance of our structures, systems and capabilities, and then hardwire the most effective into our culture as we continue to grow."


Validated year-one savings of 5.0%, third-year cumulative average savings of 12.5% and an average CAGR of 1.9% compared to the industry average of 6.5%


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