Impact of Kiio on Medical Utilization and Spend
Quartz partnered with Kiio to pilot Kiio for Low Back Pain, customized to Quartz and white-labeled as MobileBackSM. The pilot was structured to rigorously examine Kiio’s impact on member outcomes, medical utilization, and cost of care.
Quartz Health Solutions Profile
TOP COST DRIVER
Low Back Pain
The Quartz Health Solutions family of entities is a leading health plan provider servicing 350,000 members in Wisconsin and parts of Illinois, Iowa, and Minnesota. In analyzing claims data, Quartz identified low back pain as a consistent driver of both medical utilization and cost. Quartz’s medical leadership had the vision to expand beyond traditional care to provide an evidence-based, member-centric option for medically appropriate members struggling with back pain.
POPULATION AND PROGRAM
MobileBack was launched February 2017 as an invite-only pilot offered to Quartz members with a history of low back pain and residing in a limited geography in south-central Wisconsin. Potential participants had multiple visits for low back pain in the past three years and had not seen physical therapy within the last year.
MobileBack was offered free of charge via a single MyChart invitation issued by the health plan. Health plan members enrolled on a completely voluntary basis, with no incentivization other than the desire to try something new to reduce their pain.
Prior to enrolling, interested members completed Kiio’s online screening to gather baselines and confirm eligibility. Members not eligible to participate for medical or other reasons were directed to appropriate in-network care as part of Kiio’s customized care path optimization. Eligible members were provided access to the digital care program, including three progressive levels of exercise specific to the member’s type of low back pain, virtual coaching, and access to 1:1 contact with Quartz Health Coaches. Post pilot, pain education materials and additional engagement features were added to the program.
Total Medical & Pharmacy Spend
The data analysis period was February 27, 2015 through July 31, 2018, for a total of 41 months. After completing the online screening, 515 plan members were eligible to participate in the digital care portion of the program. For analysis purposes, eligible participants were split into two groups: the Kiio group (those who engaged with the program for long enough to advance beyond level one), and the reference group (those who did not engage long enough to progress past level one or who did not engage at all). Results clearly demonstrate the added value of the Kiio program on medical spend and utilization of urgent care and more aggressive diagnostics and treatments.*
Low-back-pain-related medical spend decreased 53% in the Kiio group, not including pharmacy. There was no use of ED and Urgent Care in the Kiio group post-enrollment; in the reference group, ED/Urgent Care claims increased 47%. And the Kiio group was 1.7 times less likely to have an MRI and 1.8 times less likely to have a spinal injection as compared to the reference group.
Medical Utilization & Spend
The study results demonstrated statistically significant lower medical spend for low back pain services of 53% in Year 1 for Kiio participants as compared to the reference group (p<0.01-0.05), with lower utilization of urgent care services, diagnostics, and procedures.
(% Lower in Kiio Group)
“Back pain has consistently ranked in our top three for both claims prevalence and cost. We had the vision to try something unique and innovative.”
- ELAINE ROSENBLATT, Former Director of Quality and Care Management | UW Health / Quartz Health Solutions
RESULTS: PRESCRIPTION MEDICATION
The Kiio group filled significantly fewer opioid prescriptions post-enrollment compared to the reference group over the same time period. Use of non-opioid prescription medication also decreased in the Kiio group but increased in the reference group (non-participants).*
NON-OPIOID PRESCRIPTION MEDICATIONS
“Kiio allows us to meet our members where they are with effective and convenient treatment. As a partner, Kiio has been phenomenal to work with.”
- AMANDA MESENBERG Director, Quality Management and Population Health, Quartz Health Solutions
In addition to benefiting from significant pain reduction, Quartz members have been extremely satisfied with their experiences.
“I would like to continue using Kiio. It is very helpful in controlling my pain.”
"I’ve done PT before, and I’m doing this more regularly because of the access."
"The accountability is great, and the exercise instructions are clear."
“Our goal was to provide an evidence-based, member-centric program to improve members’ quality of life and ease members’ access to care. The decrease in the cost of care was a notable result.”
- MARY PAK, MD, Medical Director | Quartz Health Solutions
An expanded claims analysis in 2019 compared MobileBack participants to Quartz book of business members using traditional care. This study demonstrated 42% to 72% lower medical and pharmacy spend in the MobileBack group as compared to the traditional care group.