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Utilization Management Health Management

Lower-cost preventive care. Better clinic access.

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Challenge

An international agriculture employer with more than 1,000 distinct members utilizing healthcare services, wanted to improve preventive care access while controlling long-term healthcare costs. Like many agriculture employers with distributed and field-based workforces, encouraging employees and dependents to consistently utilize preventive services can be difficult.

The organization needed better visibility into healthcare utilization patterns and opportunities to guide employees toward more cost-effective care settings without disrupting access to care.

Solution

Pinnacle conducted a detailed clinic utilization and preventive care analysis comparing Cedar Health Center utilization against all other provider settings.

The analysis focused on:

  • Preventive service utilization trends
  • Clinic utilization patterns
  • Diagnosis category spend analysis
  • Preventive visit cost comparisons
  • Opportunities to improve population health management through clinic-based care

Pinnacle helped the agricultural employer identify opportunities to increase utilization of Cedar Health Centers for preventive services and routine care while lowering overall healthcare costs.

Highlight Stats 

  • 1,053 distinct members analyzed
  • 19,637 distinct claims reviewed
  • $24.3M total billed charges analyzed
  • $8.24M total paid claims analyzed
  • 528 preventive-service members evaluated
  • 49% of preventive-service members utilized Cedar Health Centers
  • 22.6% lower preventive visit costs at Cedar Health Centers compared to other providers
  • $38.92 savings per preventive visit
  • Cedar Health Centers average preventive visit cost: $133.15
  • Other provider average preventive visit cost: $172.07
Results
Reduced preventive care costs through clinic utilization

The analysis showed that preventive visits completed through Cedar Health Centers averaged $133.15 per visit compared to $172.07 at other providers, resulting in approximately 22.6% lower costs per preventive visit and an estimated savings of $38.92 per visit.

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Drove strong employee utilization of clinic services

Nearly half of all preventive-service members utilized Cedar Health Centers, with particularly strong utilization among employees and spouses. In total, 260 members utilized Cedar Health Centers for preventive services compared to 268 utilizing other providers.

Improved visibility into healthcare utilization trends

Pinnacle analyzed more than 19,600 claims across 1,053 distinct members, helping the farming company better understand utilization patterns, diagnosis category spend, and opportunities to improve care efficiency and long-term population health management.

Identified high-impact healthcare cost drivers

The utilization review identified key healthcare spend categories, including:

  • $2.21M related to factors influencing health status and contact with health services
  • $1.08M related to neoplasms
  • More than $570K tied to symptoms and abnormal clinical findings

This helped create stronger visibility into population health opportunities and future cost management strategies.

See what Pinnacle Health Solutions can do for you

Reach out to learn how Pinnacle helps agricultural industry employers improve preventive wellness engagement and population health visibility through biometric screening and HRA programs.