Health Coaches

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Case Prompt

Our client is a large national health care payer (health insurance company, e.g. Aetna) exploring the launch of a new disease management program to better serve its 5 million members.

The idea is to hire and train a team of “Health Coaches” to specialize in a single disease area (e.g., heart disease, diabetes, etc.). Each coach will manage a portfolio of patients to reduce the costs of overall health expenditures (e.g., reminders to take drugs, provide limited medical advice, suggested diet, etc.). Studies show that once a month contact with each patient reduces health spending by 5%, on average.

Should our client launch the program? If so, what steps should it take?

Sample Structure

I. Background

II. Profitabiliy – Question 1: What can we get out of this chart?

II. Profitabiliy – Question 2: Which segment is likely to generate the greatest per member costs? Why?

II. Profitabiliy – Question 3: Which disease area should we look at first?

III. Conclusion

Further Questions

There is a 650K Group diabetics left “uncoached.” Is there a way to make the segment profitable?

As first to the market, the client plans to expand the Health Coach program externally. Who should they target?

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