Background

• Between 2020 and 2021, digital and virtual health investments doubled from $15B to $29B. Top funded clinical areas were Mental Health, Oncology, Cardio-Vascular, Diabetes, Reproductive Health and Neurology¹
• Employer adoption of these solutions continues to increase; in 2022, 7-in-10 employers report that they believe virtual health will significantly impact future health care delivery²

Brown & Brown Consulting Perspective on Digital and Virtual Health Solutions

Given the high rates of employer adoption, the question remains: Are these solutions delivering value and outcomes that justify the financial investment?

To answer that question, here are some general observations based on our recent work with multiple employers:

• Members are generally satisfied with the user experience of new digital health and virtual technologies, as indicated by satisfaction surveys, Net Promoter Scores, etc.
• Utilization and engagement of these new point solutions are generally higher than legacy telephonic programs (for example, remote diabetes patient monitoring vs. telephonic chronic condition management programs)

However, despite these strengths, employers who have adopted new virtual and digital health solutions generally face the following challenges:

• While leading indicators around user satisfaction and engagement rates are positive, the results are less persuasive regarding lagging indicators such as a change in clinical risk or clinical outcomes. The solutions generally show a positive change in clinical risk for only a subset of users – even though most vendors bill employers on a per-employee or per-participant basis rather than on a value-based payment schedule (per engaged member or tied to clinical outcomes).
• Vendor calculations of Return-on-Investment (ROI) are often flawed and tend to overstate the impact of their interventions. A common example is vendors calculating ROI based on the cost savings of only a subset of participants without considering the total cost of employer investment for their solution across the entire population. Employers should keep this in mind as they review vendor reports.
• Employers should ensure efficient integration between point solutions and their broader benefits to avoid duplication of services and member confusion. For example, an employee enrolled in a virtual diabetes monitoring and coaching solution may receive two separate, uncoordinated calls, one from a diabetes coach and another from the health plan case management nurse. This can lead to poor employee experience and a lack of care coordination.

We expect to see continued employer adoption of digital and virtual health technologies. These point solutions have been transformative for the employee experience and made it easier for many to manage their health and well-being. Opportunities remain to help ensure these programs deliver measurable clinical and economic outcomes and are integrated with the employer’s broader benefits.

Call to Action

Employers should develop measurement frameworks to assess the value of point solutions. Here are three questions employers should ask:

1. Is the point solution enrolling enough eligible users?
2. Are users satisfied with the overall experience in the solution, and are those users sustainably engaged on an ongoing basis?
3. Can you draw any reliable conclusions about the solution’s overall value (return) that considers program cost, clinical impact, impact on utilization/costs and member feedback?

¹ Rock Health; H1 2022 digital health funding: Two sides to every correction. Retrieved September 2022 from: https://rockhealth.com/insights/h1-2022-digital-health-funding-two-sides-to-every-correction/

² Business Group on Health; 2023 Large Employers’ Health Care Strategy and Plan Design Survey. Retrieved September 2022 from: https://www.businessgrouphealth.org/who-we-are/newsroom/press-releases/2023-lehcspds

Abinue Fortingo, MPH, CPH

Principal, Population Health Consultant

Marilyn Schlein Kramer

Partner, Head of Analytics