Salvo Health Reduces ER visits, creating path to 3:1 ROI

In our recent blog post, we published a treatment and control study showing that Salvo Health’s program decreased healthcare utilization for our treatment population, including a 79% reduction in GI-related ER utilization. This is not only a great outcome for our patients, but it yields cost savings for both individuals and the health systems. Payers haven’t focused on functional disorders, like IBS, and other mid-acuity conditions because they assume they have low utilization and spend. So, we wanted to dig in further. Working with a top actuarial firm, we used claims data from over nine million patients to analyze costs and potential savings for Salvo’s care model and the results were promising!

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Based on a 2023 Milliman study¹, the average person in the US costs $7,7221 annually to the healthcare system. This number doubles for people living with IBS - averaging $14,206 annually. With between 10-15% of the US population affected by IBS², the annual total cost of care for this patient population is considerable. IBD costs per patient average up to six times more than the US annual average at approximately $41,782. While only 1% of the US population³ lives with IBD, the costs are also significant. 

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According to the analysis, Salvo Health’s program showed a potential 3:1 ROI for commercial IBS patients - this means for every dollar spent on our program, you get three dollars back in savings annually. This number increases to $3.50 for IBS Medicare patients. For IBD, Salvo’s program showed over a 6:1 ROI for commercial patients and a 4:1 ROI for Medicare patients. Our study focused on claims groups typical of IBS or IBD diagnoses, such as emergency room visits, radiology and pathology, pharmacy and prescriptions, and specialty visits.

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Given the large patient population, 10-15% of adults living with IBS, and nearly 2x spend, there is a missed opportunity to focus on high-value care offerings in this space. This data, along with our recent study showing reductions in ER utilization for our IBS patients, continues to define the potential of tech-enabled value-based care. While CMS, payers, and health systems are looking at what is next in their value-based care initiatives to cut the cost curve, it is crucial to remember that functional GI disorders and similar mid-acuity conditions have a major impact on spend, given the high incidence of conditions with persistent symptoms. 

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Finding technology solutions to scale high-value offerings for specialty care is imperative, so we are starting with GI care. 

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Baseline Data (commercial only)

Detailed Results

Methodology

• Baseline actuarial claims data was pulled for patients with specific IBS or IBD related ICD-10 codes. Stratified sampling was used to pull commercial and Medicare populations based on likely Salvo patient demographics. 

• Conservative benchmark data and literature reviews based on Salvo Health protocols were used to determine treatment effect on utilization and cost reductions accordingly.

• Baseline and post-treatment costs were compared and analyzed in 11 different claims groups - 3 in patient and 8 outpatient / other - that were determined to be most likely affected by IBS or IBD related symptoms and treatments. ROI was calculated based on these groups.

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For more information about how you can become a Salvo Health partner, contact Amanda Sussex at amanda@salvohealth.com.