Executive Summary: Health Plan Claims Analysis Study | Reducing costs & improving outcomes in complex cases

This Executive Summary shares insights from a comprehensive, collaborative, claims-based study Teladoc recently conducted with a large health plan partner.

A combination of claims data, comprehensive case data, and metadata extracted from each case were used to compare the impact on the members’ original treatment plan after expert recommendations were delivered through Teladoc’s Complex Case Consult service.

The study examined the impact on:
  • the cost of care
  • utilization of medical services in high-cost settings
  • outcomes

The findings showed a significant drop in the cost of care for the health plan by reducing the utilization of acute services such as hospitalizations, visits to the ER, and surgeries, resulting in better outcomes for members.

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