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Health Plan
Customer Study

41% COST SAVINGS AND 2.5X PROGRAM ROI

Ontrak Delivers 41% Cost Savings
and 2.5x Program ROI for Medicare
and Commercial Health Plans

Problem

A small behavioral health population with multiple comorbid conditions was difficult for care managers to identify and engage members of their Medicare and Commercial Plans. The plan’s standard behavioral health solutions to address depression, anxiety, and SUD were not working to improve outcomes or reduce costs.

Solution

To better address this complex behavioral health population and improve outcomes, the Health Plan selected Ontrak’s solution to identify members with unaddressed behavioral health, establish trust to improve engagement, help remove barriers to care, and connect them to behavioral healthcare providers.

Identify

Ontrak’s predictive analytics identified

3% of all Medicare and Commercial Members

with behavioral health conditions, including those without a previously identified diagnosis, representing $158 million in total annual paid claims.

$28,000

average PMPY paid claims, 6 times more costly than the rest of the Plan’s population.

Average of 3.6

chronic conditions, such as diabetes, COPD, high blood pressure, and obesity.

Engage

Our Member Enrollment Specialists and Care Coaches drive new program enrollment and persistent engagement with a whole-person, member-centric approach that provides SDOH support and addressed barriers to care.

Treat

Ontrak contracted with this Health Plan’s network providers using a collaborative care approach. Members participate in up to 52 weeks of a coach-guided and therapist-led behavior change program, tailored to address individual health goals, that include regular in-person or telehealth visits with licensed therapists, psychiatrists, and addiction specialists.

Activate

Upon graduation, members overcome or manage social risks and other barriers to care, have increased health literacy, and developed the skills and self-efficacy to proactively manage their conditions and overall health. Importantly, activated members experience effective care transition and are actively engaged with their PCPs, behavioral health providers, and their health plan.

Financial and Utilization Outcomes
41%
PMPM Cost Savings
2.5x
Return On Investment
43%
reduction in ED utilization
68%
reduction in inpatient admissions
Engagement Outcomes
26%
average program enrollment rate
7+
months average time enrolled in the program
43%
program graduation rate
75
Member net promoter score