Beyond Traditional Case Management: Solutions for Today’s Complex Workforce
Costs are climbing
Employers face increasing pressure to deliver robust benefits while managing rising health care costs. The traditional approach to case management—often narrowly focused and reactive—no longer meets the needs of complex, diverse, and evolving workforces.
- Workpartners’ Research Reference Database—built from about 500 million claims from 5.7 million members—shows that cases costing more than $100,000 per year have risen 37 percent since 2018 (now about 9 per 1,000 members. Those costing more than $500,000 a year are up 31 percent. This pressure is felt across industries and employer sizes.
- When total human capital costs are considered (medical, pharmacy, absence, disability, and workers’ compensation), the top 5 percent of employees account for about 59 percent of overall costs, underscoring the need to predict and intervene early.
How Can Workpartners Help?
KnovaSolutions Clinical Support Program
KnovaSolutions® is Workpartners’ holistic clinical decision support service. It is designed to aid high‑ and emerging‑risk employees in your clients’ populations. The KnovaSolutions’ multidisciplinary clinical team uses person‑centric analytics from our Human Capital Risk Index® (HUI) to identify who is most likely to drive outsized medical and productivity costs. Team members then engage those individuals to reduce waste, improve decisions, and shorten the duration of high‑cost events for your clients.
The HUI advantage: Leading indicators, not rear‑view mirrors
A cornerstone of our analytics is the HUI. Built from Workpartners’ Research Reference Database, the HUI takes into account data on lost time, medical and pharmacy claims, and workers’ compensation to assess risk and predict high-risk and high-cost cases.
Most reports show past high‑cost claims. HUI provides forward‑looking risk information, incorporating compensation and lost‑time data with medical and pharmacy claims to flag high‑risk (top 5 percent) and moderate‑risk (next 15 percent) individuals before their costs peak. This enables us to provide HIPAA‑compliant outreach and targeted prevention for your clients.
- In the HUI profile, the top 5 percent cohort shows a HUI score of about 1 versus 1.0 for the remaining 95 percent, reflecting markedly higher future risk and expected spend.
- HUI’s person‑centric inputs (claims, disability, absence, workers’ comp, compensation, and performance/HR signals) deliver greater predictive power than medical/pharmacy‑only warehouses.
How KnovaSolutions works: Identify → Invite → Engage → Improve
- Identify: HUI flags individuals trending to high cost. Integrated data pinpoints complexity (multiple conditions, polypharmacy, fragmented care).
- Invite and Enroll: Multichannel outreach (calls, letters, emails) yields more than 70 percent enrollment among high‑risk employees, reflecting their need for support to navigate a fragmented system.
- Engage: A multidisciplinary team (registered nurse, pharmacist, dietitian, certified diabetes care and education specialist, and medical research librarian) delivers tailored guidance on conditions, medications, lifestyle, and provides clarity in navigating the health care system.
- Improve: The program accelerates the typical post‑event cost decline, shortening the high‑cost period and producing tangible savings in year one.
Results your clients can measure
In a 2023 multi‑employer pre/post study (6,589 graduates across 35 companies):
- Health plan costs declined 46 percent (primary care, specialty, ER, and pharmacy combined).
- Lost‑time costs declined by 64 percent (faster, safer return to work).
- Total costs declined by 47 percent (health plan and lost time).
- Participants saw 36 percent fewer providers and had 28 percent fewer diagnoses. Tests declined by 39 percent, and medications fell by 18 percent. These statistics indicate better care coordination and fewer duplicative services.
- Participants’ HUI scores fell from 4.3 to 2.8 (down 35 percent) by graduation, signaling sustained risk mitigation for the clients’ populations.
- ROI was 2:1 to 5:1 versus statistically matched comparison cohorts.
Bottom line for rising health care costs
Addressing the rising number of high‑cost cases requires predictive, integrated analytics and high‑touch clinical prevention. HUI pinpoints who will be both high‑risk and high‑cost, and KnovaSolutions shortens the cost curve—resulting in risk reduction, faster recovery, and sustained savings for your clients.
Learn More
Watch our webinar: To dive deeper into how KnovaSolutions can transform employee health and deliver measurable business impact, watch our recent webinar. It features expert insights, real-world case studies, and a Q&A with our clinical team. Whether you’re a broker or an employer, this is a great opportunity to see how KnovaSolutions helps organizations proactively manage risk, reduce costs, and empower employees.
Success Story: Read how Workpartners teamed up with a client to improve employees' diabetes management and lower treatment costs
Executive Spotlight: Stephen Doyle, MS, MBA, RCEP
Stephen Doyle is the Assistant Vice President of Advocacy at Workpartners, a position he has held since 2021. In this role, Stephen oversees and leads all aspects of Workpartners’ Advocacy line of business, ensuring that clients and members receive exceptional support and guidance throughout their health and benefits journey.
Stephen has been a valued member of Workpartners since 2005, bringing nearly two decades of experience and dedication to the organization. His academic background includes an MBA in Applied Business from Waynesburg University, a Master of Science in Exercise Science and Health Promotion with a focus on Rehabilitation Science from PennWest California, and a Bachelor of Science in Exercise Science and Health from Huntington University.
In addition to his academic achievements, Stephen holds several professional certifications, including Clinical Exercise Specialist and Registered Clinical Exercise Physiologist from the American College of Sports Medicine, as well as Corrective Exercise Specialist from the National Academy of Sports Medicine.
Stephen’s leadership and expertise have been instrumental in advancing Workpartners’ Advocacy initiatives, helping to deliver personalized, impactful solutions for clients and their employees.
Supporting Healthier Workplaces: The Value of Wellness and Clinical Programs for Your Clients
Offering benefits that support employees’ health and well-being is a strategic investment. By having comprehensive wellness and clinical programs available, your clients are empowered to proactively address health risks, enhance workforce vitality, and foster a culture of well-being. These solutions can not only improve individual health outcomes but drive organizational resilience, productivity, and long-term cost savings—resulting in healthier, more successful workplaces.
Discover how Workpartners’ suite of wellness and clinical programs can make a meaningful difference for your clients.
Workpartners’ employee assistance program: Supporting employee well-being
Helping employees maintain their mental and emotional well-being has been Workpartners’ mission from the start. Our employee assistance program (EAP) is designed to help your clients support their employees’ mental, emotional, and financial well-being—leading to a more engaged and productive workforce. The EAP offers 24/7 access to counseling (in person, by phone, via video, or by text message), referrals to thousands of community resources, and digital health tools. The program provides specialized support for leaders—including resilience training, conflict resolution, and disruptive event management—as well as tailored services for unique populations such as health care workers, educators, and first responders.
With more than 13,000 organizations served and a 97 percent client retention rate, Workpartners’ EAP is a proven partner for companies seeking to proactively address workplace challenges.
The program delivers a strong value proposition: Organizations typically see a return of $3 or more for every $1 invested, and companies with EAPs experience 27 percent less absenteeism than those without.
By integrating EAP services with powerful data analytics and clinical solutions, brokers can help their clients foster a culture of well-being, reduce costs, and improve overall organizational health.
Well‑being engagement platform: A turnkey digital solution that boosts engagement and proves ROI for your clients
Workpartners’ well‑being engagement platform centralizes benefits, surveys, events, and wellness activities in a Member Resource Hub branded to your clients. With real‑time analytics, flexible incentives, and social features, you can help your clients increase participation, reduce risk, and see measurable outcomes across their employee populations. The platform aligns to each client’s priorities and integrates seamlessly with assessments, coaching, and clinical programs.
Wellness programs: Clinically developed solutions that reduce risk and costs for your clients
Workpartners’ wellness portfolio—assessments, screenings, incentives, lifestyle management, stress and weight programs, tobacco cessation, nutrition education, and health coaching—can deliver proven improvements for your clients’ employees and measurable cost containment for your clients’ plans. Use these programs to build comprehensive, outcome‑driven strategies across your book of business.
Success Story: Learn how we helped one of our clients develop a culture built around employee wellness.
MyHealth Questionnaire: Fast, whole‑person insights to inform targeted strategies for your clients
Recommend the MyHealth Questionnaire to give your clients a quick, 10‑minute view of their workforce’s health. Employees receive immediate, personalized results, and leaders get executive‑level reporting to identify high‑risk trends, prioritize interventions, and track progress over time. Use these insights to guide your clients’ program design and quantify impact on health and costs.
Health coaching: Personalized coaching that improves outcomes for your clients’ employees
Workpartners’ board‑certified health coaches and licensed care managers support sustainable lifestyle change, chronic condition management, and behavior health goals—driving measurable improvements across your clients’ populations (e.g., reduced stress and anxiety, better nutrition, weight loss, and increased activity). Flexible telephonic and virtual coaching options make implementation simple for hybrid and remote workforces.
Onsite care and clinics: Delivering convenient, cost‑effective health care for your clients
Workpartners’ student health clinics deliver customized, onsite care designed to help universities keep students healthy, engaged, and productive. These clinics offer a broad range of services—including acute care, wellness programs, immunizations, behavioral health support, pharmacy services, and health coaching—through onsite, virtual, or hybrid access models.
Active&Fit Direct and ChooseHealthy: Wellness perks you can package to enhance your clients’ benefits
Through Active&Fit Direct™ and ChooseHealthy®, your clients’ employees gain access to thousands of gyms, on‑demand workouts, and discounts on leading wellness products and specialty providers. These perks reinforce physical activity and healthy habits—helping you differentiate your offering and elevate perceived value for your clients.
HaPPI: A strategic assessment you can deploy to elevate your clients’ culture and outcomes
Workpartners’ Health and Productivity Performance Index (HaPPI) evaluates six dimensions—policies, resources, environment, leadership, communication, and engagement—to deliver actionable insights that can help your clients strengthen their workplace culture and productivity. Use HaPPI to benchmark performance, target interventions, and demonstrate how your guidance is driving health and cost improvements for your clients’ organizations.