Case Study: St. Joseph Hospital achieves $2.5M (12% PMPM) savings with MedeAnalytics Population Health solution

St. Joseph Hospital Achieves 12% Savings with Population Health Data

St. Joseph Hospital, one of three facilities in the Covenant Health system, needed better insight into rising self‑insured employee health costs as it shifted from volume to value-based care. Without analytics they couldn’t segment cost drivers or validate assumptions about high‑risk patients, ER use, and pharmacy spend, so they engaged MedeAnalytics’ Population Health solution and Consulting Services to analyze claims, stratify risk, and guide benefit design.

Using MedeAnalytics, St. Joseph identified that 9% of highest‑risk employees accounted for 40% of plan costs, uncovered that pharmaceuticals were 25–27% of spend with specialty drugs driving much of it, and found at least $100,000 in generic substitution opportunities; one patient’s drug cost fell from $700 to $9 after intervention. MedeAnalytics’ analytics and consulting helped redesign plan incentives, reduce PMPM costs by 12%, and put the hospital on target to spend $2.5 million less in 2016 versus 2015 while building a foundation for value‑based care.

St. Joseph Hospital

Richard Boehler

CEO