From Joy to Value: Quantifying ROI of In-Home Foot Care for Medically Complex Health Plan Members

Belle provides In-home foot care (medical pedicures) for members of Medicare Advantage plans, as well as Chronic Condition Special Needs Plans (C-SNPs). We consistently receive glowing reviews from members and fare incredibly well on all satisfaction measures, including maintaining a NPS of 98. Creating joy for individuals is core to what we do as a company, because it is a catalyst for forming trusted relationships with the members we serve. Those relationships lead to direct clinical and financial value for our clients.

To quantify how joy can lead to measurable and meaningful value, we recently put our services to the test by performing multiple retrospective cohort studies.

Our services are specifically designed to produce both clinical and financial outcomes. We accomplish this by closing a critical gap in care: foot care. For people with complex conditions such as diabetes, kidney disease and obesity, maintaining good foot health is key to improving well-being and preventing unnecessary healthcare utilization and cost. Unfortunately, many of these individuals fail to receive routine or preventive care. Without taking proper steps, they risk falls, visits to the ER and a host of other health complications. In diabetes alone, a third of all spend is driven by foot ulcers and amputations, of which 85% are preventable with regular care.

During each in-home visit, our technicians provide a spa-quality medical pedicure where they test for neuropathy and conduct a robust evaluation of overall foot health. We also conduct an assessment of whole health: pre-post visit photos of the lower extremities, clinical screenings, social determinants of health and fall risk screenings. Within 4 hours, Belle’s remote nurses review visit data and, if warranted, open a clinical case to ensure members are connected with support and care coordination with PCPs, podiatrists, case management and other in-home care providers.

To document the difference Belle makes, we examined our incremental impact on (1) Total Cost of Care (”TCoC”), (2) In-Home Wellness Assessment Completion (”IHWA”), and (3) Voluntary Disenrollment. For this analysis, we examined outcomes for both “lower risk” MA populations as well as “higher risk” C-SNP populations.

Our findings demonstrate that the effective delivery of in-home foot care results in meaningful outcomes for Medicare Advantage and C-SNP plans across multiple value propositions. Just as interestingly, we verified that such an offering can generate positive ROI for both healthier, low-risk groups as well as more medically complex, high-risk populations.

Specifically, our analysis observed the following.

For the low-risk population:

>> Total Cost of Care Reduction: $800 Per Engaged Member Per Year (By decreasing the number and severity of unnecessary procedures/claims for members with timely intervention, we produced incremental savings that resulted in a significant reduction in PEMPY costs)

>> Incremental In-home Wellness Assessment (IHWA) Completion: 49% Scheduled Rate (In other words, nearly half of members who previously declined an IHWA agreed to participate after speaking with a Belle Technician.)

>> Incremental Member Churn Reduction: 9% (We observed decreases in voluntary disenrollment when comparing members that received Belle and those that did not.)

>> Resulting in a 2:1 ROI

For the high-risk  population, the results were even more dramatic.

>> Total Cost of Care Reduction: $1500 PEMPY

>> Incremental IHWA Completion: 49% Scheduled Rate

>> Incremental Member Churn Reduction: 32%

>> Resulting in a 4:1 ROI

We take a very conservative and transparent approach to measuring the impact of our services so we can offer clients a credible ROI.  Our rigorous measurement methodology allows for an accurate observation of the specific results we produce. This allows us the confidence to put up to 100% of our fees at risk.

If you want to learn more about our recent ROI analysis, you can click here to download the full report. If you want to better understand how our services work, or how we measure value, please contact us for a consultation.