Business Insurance RMIS Article

"Benefit ‘dashboards’ aid SCANA’s drive to cut costs"

December 5, 2005

by JOANNE WOJCIK

COLUMBIA, S.C.—As a scientist, it was only natural that Chris McSwain, director of compensation and benefits at SCANA Corp., would develop his own system for measuring the performance of the various company benefit programs.

Mr. McSwain's team is taking a running tally of everything from how many employees, retirees and their dependents visit the LiveWell Resource Center, to how many referrals are made to the health coach and even how many pill splitters are issued.

Crystal Smith, administrative assistant in the LiveWell Resource Center, has perhaps the largest number of metrics to collect. Among them are: the number of speakers' bureau requests and number of presentations given; the number of employees attending the presentations; the number of video, book and brochure requests; the number of e-mails to AskLiveWell, the resource center's e-mail address, which Ms. Smith is responsible for monitoring; the number of appointment requests through AskLiveWell; and the number of total phone calls to the resource center.

She also tracks usage of the HealthSmart Web site, using reports provided by the vendor that include such information as the number of unique site visits; number of registered users; the most popular areas of the site visited, such as weight, blood pressure control, cholesterol, men's health, women's health, etc.; and how many visitors are using the medical cost comparison tools, plan comparison tools and/or medication comparison tools.

"It tells me every page they went to—say, 10 people went there; five went there," she said.

On a monthly basis, Ms. Smith also is responsible for obtaining the pharmacy metrics collected by SCANA Pharmacy Manager Daniel Bundrick; the wellness metrics from Health Coach LaTonya Davis; and Life Assistance metrics from Sara Delk, the wellness program administrator.

Careful measuring

The metrics Mr. Bundrick collects include the total expenditures for prescriptions as well as the number of: prescriptions filled; generics; consultations and/or interventions provided by the pharmacy; AskAPharmacist queries, which he is responsible for answering; prescriptions switched from preferred/nonpreferred to generic; pill splitters issued; seminars conducted; referrals to the health coach, Life Assistance or to the CIGNA PBM; and drug interactions found.

Among the metrics Ms. Davis collects are the number of: consultations; Healthtrak assessments completed; presentations conducted; and referrals to either the pharmacy or to Life Assistance.

Ms. Delk collects metrics on the number of: Life Assistance consultations; referrals to CIGNA Behavioral Health counselors; calls to the toll-free assistance line; and referrals from Life Assistance to either the pharmacy or the health coach.

All of these metrics are assembled into a single, color-coded chart that is presented monthly to SCANA's top management, with a running tally of the services used, benefit costs and any other measurable information.

In fact, these monthly "dashboards," as they have been dubbed, are what led Joe Bouknight, senior vp of human resources, to write the letter nominating Mr. McSwain for the Business Insurance Benefit Manager of the Year competition.

That's how he and other members of senior management discovered that the 201% increase in health care spending that had occurred over the three years before Mr. McSwain joined SCANA was reversing itself, Mr. Bouknight said.

"When I first heard about the opportunity (to nominate Mr. McSwain), my initial reaction was maybe we're a year early. But when we put together a list of everything that was accomplished," that provided the impetus, Mr. Bouknight said.

"If I were not really comfortable that this stuff is going to work, I wouldn't have written the nomination letter. But we're getting so much positive feedback within the company. The volume in the pharmacy is steadily increasing. The health coach is engaging people. We were absolutely amazed by how many peoplehave already gone online and did the health risk assessment (85% by late October), and they're doing it candidly, because there is a high percentage of people at risk," he said.

Evidence of success

Indeed, tracking the volume of people going into the resource center, as well as the services they are using, and health care costs, ismaking it easier to demonstrate the value of the changes to SCANA's management, Mr. McSwain said.

"So if some senior exec asks, `How do we know this is actually making a difference?' I've got data. It's important to demonstrate the value this adds, and there are so many new things that we're doing, we want to measure how things are working so we know where to make adjustments and direct changes."

Mr. McSwain also is using the findings of his data collection project as leverage to improve the service provided by the company's various benefit plan vendors, which ultimately should produce even more improvements in the health and well-being of SCANA's employees.

For example, when Mr. McSwain compared the pharmacy metrics with the usage of behavioral health care services in the resource center, he found a discrepancy.

"Of all the areas that we measure in the LiveWell Resource Center metrics, the least-performing is behavioral health. But when we look at the top drugs dispensed by the pharmacy, No. 5 and 6 are antidepressants," he said.

Armed with this data, Mr. McSwain approached CIGNA Behavioral Health, SCANA's mental health care vendor, and asked the company to improve its service model.

"The best of their thought leaders will figure out what they need to do to their service model to change it so we can tap more effectively into the demand that we know exists by our pharmacy data," he said.

"That is how measuring things in one area has helped me more effectively partner and manage the vendor on another side. I never would have known that if hadn't been looking at my pharmacy spend and measuring the utilization of the behavioral side of the resource center," Mr. McSwain said.