Case Study: Third-Party Administrator achieves 4:1 ROI and improved clinical and financial outcomes with Conifer Health Solutions

Third-Party Administrator Achieves Steady Growth and Improves Employer Clinical and Financial Outcomes

Third-Party Administrator, an established TPA managing more than 150,000 lives and serving employer and union groups with customizable, competitively priced self-funded benefit plans, needed an innovative, integrated population health management solution to deliver high-quality, cost-effective medical management for its employer clients. In 2010 the Third-Party Administrator partnered with Conifer Health Solutions, adopting Conifer’s population health/Care Continuum solutions to gain a unified, actionable view of member populations.

Conifer Health Solutions implemented a data-integrated population health platform and a “one population, one nurse” care-management model that uses risk stratification and predictive analytics to target high-risk, high-cost members and maintain ongoing follow-up. The partnership produced measurable impact: covered lives more than doubled (70,000 in 2010 to 150,000 in 2016), a 4:1 ROI ($4 saved per $1 invested in 2016), and member engagement rates around 70%, while delivering sustainable, cost-effective care management and URAC-accredited services.