MedExpert
The MedExpert
difference, in numbers.
Across highly varied client populations, MedExpert has produced ROI in the 10:1 to 16:1 range — and reaches 20:1 year-over-year in larger populations (>100,000 members). The numbers below come from validated deployments across all 50 states.
Healthy members,
reduced costs.
Validated outcomes come from more-appropriate utilization of care resources, lower claim counts, reduced ER visits, and reduced duplicative and unnecessary testing. Appropriate care choices push down hospital recidivism and reduce unnecessary elective surgery.
Decrease in emergency room use across deployed populations.
Decrease in overall medical spend.
Decrease in inpatient stays, reoperations, and outpatient procedures.
Population-scale evidence.
Engagement & satisfaction
- More than 85% of all beneficiaries were touched
- 45%+ engaged medically at a "low intensity" level
- 12% engaged medically at a "high intensity" level
- 95% of participants rated MedExpert "Excellent"
- 99% said they would participate again
Clinical impact
- 67.30% improved their blood pressure
- 58.50% improved their glucose values
- 50.79% improved their cholesterol values
- Services on 1,800+ unique medical topics
- Reduced readmissions and reoperations
Opioid reduction at scale.
Among a group of "super-utilizers" in a Medicaid population — 5,107 members — MedExpert's interventions significantly reduced opioid utilization year over year. Care coordination and care management commenced January 2015; the year prior establishes the baseline.
Note: 2017 results subject to claim lag. Last claim load shown occurred October 2017. Data reported by incurred date.
Medicare
CMS / CMMI Pilot.
A 144,456-beneficiary Medicare deployment compared the May 2013 – Feb 2014 base year to the MedExpert service period of May 2014 – Feb 2015. Net effect across the population: meaningful reductions in inpatient utilization without restricting access.
Claims incurred through February 28, 2014 and paid through April 5, 2015. No completion factors applied.
−15%
Inpatient hospital admissions
−15%
Skilled nursing facility utilization
85%+
Population engagement rate
Member-driven, evidence-grounded.
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