Table 3.
Estimated Program Savings and Cost–Benefit Analysis
| Post-Program Engagement | ||||||||
|---|---|---|---|---|---|---|---|---|
| +30 days | +60 days | +90 days | +120 days | +150 days | +180 days | |||
| Estimated Savings related to reduced PMPM | ||||||||
| Intervent. Avg Post Risk-Adj PMPM X 6 mo Control Post Cost Trend Risk Adj(4.1%) | $359.59 × 1.0413.5 = $413.89 | $430.86 | $448.52 | $466.91 | $486.06 | $505.99 | ||
| Risk Score | 3.03 | 2.99 | 2.98 | 2.94 | 2.88 | 3.07 | ||
| Unadjusted PMPM | $1252.88 | $1288.18 | $1336.96 | $1375.05 | $1401.45 | $1551.51 | ||
| Minus: | Actual Int. Cost PMPM | $1108.19 | $977.29 | $821.92 | $903.00 | $928.02 | $949.42 | |
| Equals: | Estimated Savings PMPM | $144.69 | $311.65 | $515.03 | $472.05 | $473.43 | $602.09 | |
| Multiplied by: | Membership | 1056 | 1017 | 978 | 935 | 955 | 898 | TOTAL SAVINGS: |
| Monthly Estimated Savings | $152,792 | $316,948 | $503,704 | $441,371 | $452,121 | $540,676 | $2,407,612 | |
| −35% | −24% | −39% | −34% | −34% | −39% | |||
| TOTAL COSTS of IMPLEMENTATION: (salary + benefits of providers, mileage costs and% of fixed costs) | $810,000 | |||||||
| Return on Investment: | 2.97 | |||||||
Adj, adjustment; Avg, average; Intervent, intervention; PMPM, per member per month