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Examining How Mobile Apps Can Help Bend the Cost Curve
March 18, 2019

Examining How Mobile Apps Can Help Bend the Cost Curve

Randy Tomlin is CEO and Chairman of the Board for MobileSmith. In his position, Randy directs the company’s strategic growth and operational excellence, and is responsible for the successful proliferation of the company’s mobile app technologies throughout the healthcare spectrum.
No one wants to develop a debilitating disease, an aggressive cancer or a chronic condition such as diabetes that requires constant care to manage. Neither does anyone want to get into a horrific accident or have a congenital defect that brings a lifetime of consultations, treatments and surgeries.

But these events occur every day, which is why health insurance is so important to Americans.

Despite spending twice as much compared with 10 other high-income countries as a percentage of the GDP, however, Americans have the lowest estimated lifespan and the highest infant mortality rates. Americans access healthcare at the same rate as people in other countries, according to a study in JAMA. Across the board, however, prices are higher in the U.S. for prescription drugs, surgeries, scans, provider salaries, and administrative costs.1  

In the wake of the Affordable Care Act and state expansion of Medicaid, the uninsured rate dropped to 8.8% in 2017. 2 But having insurance doesn’t necessarily mean that one can afford to become sick or injured. Ten percent of all Americans report delaying or avoiding care because of cost. But nearly 2 times as many (19%) who describe their health as less than “good” say they will skip care. People with low incomes and uninsured adults are also more likely to delay or skip care.3

As costs continue to spiral, companies are working with brokers to maximize the value of their healthcare dollars, focusing on preventive care and increased use of the most-appropriate care setting based on a worker’s illness or injury.

Access to in-network care and appropriateness of the care setting can influence worker costs, making education and engagement paramount. When deployed as part of a member’s health plan, mobile apps can direct patients to the most cost-effective and appropriate care, be it a physician, specialty provider, urgent care clinic, telehealth visit or hospital. Apps can also help members manage their chronic conditions, receive cost estimates and ensure providers and facilities are in-network.

The results are better, more appropriate healthcare usage, better-informed patients and lower costs for employers.

Costs continue to spiral

For 2019, the average estimated cost of healthcare for employees and dependents, including premiums and out-of-pocket expenses, is $14,800, a 5% increase from the previous year. Large employers generally cover 70% of outlays, leaving employees responsible for more than $4000 in expenses.4  

In addition, the reliance on self-insurance increases as employee headcount does. Sixty-one percent of covered workers overall are in partially or wholly self-funded health plans, with 87% of workers in companies with 1000-4999 employees and 91% of those in companies with more than 5000 workers in self-funded plans.5
 
Companies that offer insurance walk a fine line between keeping costs low enough to retain employees while containing a semblance of control over usage. Working with brokers, companies can design plans that reward appropriate use, offering self-service tools such as mobile apps to provide guidance. Such plans can also offer extra support to those with chronic illnesses such as diabetes to keep manageable conditions from becoming costly hospital stays.

As costs escalate to untenable levels, companies and insurers are offering less expensive plans that carry high deductibles before insurance kicks in—shifting more of the financial burden onto patients. A high-deductible insurance plan (HDHP) coupled with a health savings account (HSA) carries an individual deductible of between $1350-$6750, double that for family coverage. Employers often fund a portion of the HSA as well, which can be used for qualified medical expenses. Employee contributions up to a limit ($3500, individual; $7000, family) are counted as pre-tax dollars and can be rolled over into subsequent plan years. Those 55 and over can contribute an additional $1000.6

For the 2017 plan year, nearly 22 million people were enrolled in HDHP/HSAs, an 8% increase from the previous year.7

The high price of sick workers

Employers have a significant vested interest in keeping workers healthy to boost productivity and keep healthcare costs low. Productivity losses are estimated at $1685 per employee, or nearly $226 billion annually. Of those losses, two-thirds are attributed to presenteeism, employees who are on the job but not at their best. Presenteeism decreases productivity and contributes to workplace epidemics. Lost productivity due to chronic pain accounts for 5% of that total, or about $12 billion.8

Much of the productivity loss can be attributed to conditions that can be managed with proper care and monitoring.


 
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