Externally validated methodology generates condition-specific cost savings across the 15 leading cost drivers
NEW YORK, February 1, 2023 — Summus, the leading virtual specialty care provider, today unveiled an industry-first, proprietary methodology to quantify the return on investment (ROI) for organizations using virtual specialty care services. The new methodology, validated by Milliman, a leading actuarial firm, delivers dependable medical cost ROI. Amid an access and affordability crisis in healthcare, employers and health systems seek to align health expenditures with clear ROI data to support better, more cost-efficient medical decisions.
Summus’ approach solves the ROI attribution problem present in trend analysis and aggregated health conditions by analyzing episodic, condition-specific cost savings, compared to common practice of trend-based ROI. The methodology accounts for the impact of Summus’ virtual specialty care solution that avoids expensive in-person visits, changed treatment paths, and avoided surgeries across medical conditions that drive cost in specialized care.
Impact is determined using control and treatment cohorts created from populations matched to the patient with geolocalized costs. Total medical cost savings are calculated using data from member and physician consultations and surveys, and a third party claims database of more than 340 million patients from commercial, Medicare and Medicaid populations. Patient journey data is constantly updated, providing an accurate, dynamic ROI medical cost savings.
“In 2023 and beyond, both employers and health systems are increasingly focused on the financial return and impact on health outcomes that virtual health solutions offer. Trustworthy data-driven models are a critical foundation,” said Mary Mulcare, MD, Chief Medical Officer at Summus. “We offer employers and health systems the first ROI methodology that provides virtual specialty care savings calculations using large data sets and accurate analysis. Understanding the financial impact of medical care and providing a new approach to accessing specialists around the world will help us address the cost and complexity in specialized care.”
The Summus ROI methodology has been reviewed and validated by Milliman, a renowned worldwide actuarial firm that is expert in studying health and financial wellbeing.
Milliman found the methodology is consistent with actuarial practices to estimate the net financial impact of a program of this nature. Summus’ estimated savings calculation approach aligns closely with the business model, the services provided, and the program features that drive savings; supporting the approach, data employed, and assumptions made.
By focusing on the drivers of healthcare cost and complexity and accelerating access to the nation’s best medical advice, Summus is able to achieve medical cost savings across the spectrum of health diagnoses and conditions. The Summus curated physician network of 5,100+ leading specialists empowers members and their families to make informed healthcare decisions that are right for them and drive better, cost-efficient outcomes across all health questions and journeys.
For more information about Summus’ ROI methodology that captures the cost and harnesses the complexity in specialty care, visit: https://gosummus.info/ROI.