Comparing costs and claims in a group of 1,000 people in traditional settings vs. Sherpaa

Let’s take a group of 1,000 and analyze how they use healthcare for a year. First, we’ll look at their traditional usage leveraging PCP office visits, specialist visits, urgent care centers, and ERs. Then, we’ll look at how they use healthcare with Sherpaa.

Traditional Usage per 1,000 employees

Sherpaa Usage per 1,000 Employees

First, some background. Sherpaa encourages people to reach out to our doctors first, except for glaringly obvious emergencies. This gives us an opportunity to diagnose and treat issues virtually or strategically coordinate care with local specialists and facilities for when in-person care is needed. Users, on average, create 2.7 episodes of care per year for a total of 2,700 episodes per year for this population. An episode of care can last 3 days for a UTI, 3 weeks for a pneumonia, or 3 months for a breast cancer scare. This means one episode of care is equivalent to 1 to many traditional office visits. Our 7 years of data shows that 80% of all episodes of care are handled virtually with our PCPs + our virtual specialists without in-person visits. However, 20% of episodes do need to be seen in-person.

So, for this population of 1,000 Sherpaa users:

Comparing the usage and costs for this population

Why are there so few total visits? Unlike traditional care, we are not in the business of maximizing office visits. For example, an episode of care for pneumonia would last 3 weeks with every few day check-ins between you and your Sherpaa PCP. This would not be an initial office visit with one to two follow-up office visits as you’d see in the traditional space. It’s also not a visit to an urgent care center and a follow-up to a PCP or specialist afterward. It’s just one $100 episode of care.

As you can see, the following two-pronged strategy works extremely well.

This enables our two-pronged approach to reducing total spend:

#1: Eliminate as many unnecessary traditional claims as possible. Because 80% of everyday issues do not need in-person management (this is based on 7 years of operational data), office visits and claims significantly decrease.

#2: Strategically direct as many in-person traditional claims as possible. Our experienced physicians who expertly understand how in-person care is delivered know how they can optimize how and where people get in-person care.