A Proactive, Forward-Looking Clinical Care Strategy

October 5, 2023

Six in 10 adults in the U.S. have a chronic disease. Heart disease, cancer and diabetes are driving high levels of disability, death and $4.1 trillion in annual healthcare costs, according to the Centers for Disease Control and Prevention (CDC).

Industry research also shows that millennials are outpacing other generations when it comes to chronic conditions and healthcare system utilization — 106% more hospital admissions for those with diabetes and 55% more emergency room and urgent care visits for hypertension.

These unsettling trends show chronic diseases are hitting Americans at younger and younger ages. It’s a bleak situation that has employers grappling with how to control healthcare costs despite the increasing needs for accessible and affordable care.

We desperately need new, highly collaborative approaches to engaging patients earlier before these conditions turn chronic.

A Refreshingly Innovative Approach

At Gravie, our clinical strategy is focused on improving health outcomes and creating affordable avenues for both employers and employees. While this strategy isn’t novel, how we’re actually delivering on this vision is.

With Gravie’s Comfort® plan, members are encouraged to take advantage of routine and preventive care without worrying about costs. Most common healthcare services — from urgent care to labs and imaging to mental health care — are 100% covered with Comfort. And this solution is rapidly expanding to include a world-class ecosystem of individualized programs, specialists, and pharmacy benefits — all in one platform, in an effort to effectively improve the experience of using health benefits.

Early Intervention

For most group health plans, costs are typically driven by a small majority of members, many of whom deal with specific conditions. At Gravie, we believe that taking a hands-on approach with this population is key. Looking at the data, we’re concentrating on the following chronic conditions, bringing more effective resources, services and guidance to members in these areas:

  • Musculoskeletal conditions
  • Digestive disorders
  • Circulatory diseases
  • Cancer
  • Diabetes

With early intervention, we can help determine what type of support or new care a member needs most – from help with picking up medications and finding transportation to appointments, to better understanding what physical therapy options are available and how they could make a lasting difference.

By prioritizing preventive and primary care, Gravie strives to guide members in real time, build trust with providers, and support each member’s unique health journey by working closely with primary care teams. We’re not making a guess in the dark, nor are we implementing a one-size-fits-all approach; we’re logically following what the data tells us as we enable engagement through individualized communications and care plans.

A Forward-Looking Approach

Whether developing a clinical strategy, underwriting a policy, or pricing a health plan, it’s easy to look in the rearview to make decisions based off past events. But that’s not how human health works. For instance, even though an individual may have broken their arm in an accident last year, that doesn’t necessarily mean they’re at a greater risk for doing so in the future. An appendectomy one year, certainly won’t happen the next. Rather than only looking backwards, we’re using smarter analyses and member assessments to paint a better picture of where an individual is heading, in order to more accurately assess risk and to plan for interventions and support.

Building an Ecosystem of Clinical Partners

Leveraging the right experts for the right types of services and intervention is paramount. By partnering with other health and wellness innovators like Sword for physical therapy and Teladoc Health for virtual care services, mental health treatment, dermatology consultations and more on the way, at Gravie, we’re reimagining what great health coverage looks like. These services are automatically included in the Comfort plan for a seamless user experience.

Through a more common-sense approach that focuses on smarter healthcare utilization, earlier intervention with the right clinical partners, and forward-looking risk assessment to inform our care strategies, we have the power to significantly change the tide on our nation’s healthcare climate. This approach is reducing costs, improving outcomes and giving individuals and their family the healthcare experiences they deserve.

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