New Sun Life program gives members quick, direct access to health services

Rhea-AI Summary

Sun Life U.S. has launched Clinical 360+, a stop-loss program designed to improve health access and outcomes for members. This new offering expands on the original Clinical 360 program, providing personalized resources, tools, and care services to help members better manage their health. The program includes:

• A specialty and infusion drug program
• At-home kidney and heart care management
• A musculoskeletal condition program
• Access to care advocacy and navigation
• Sun Life Health 360 mobile app

Clinical 360+ is available to small-to-mid-sized self-insured employers using third-party administrators. Sun Life, the largest independent stop-loss provider in the U.S., covers high-dollar claims for self-insured customers. According to the Kaiser Family Foundation, 65% of covered employees in the country are enrolled in self-funded plans as of 2023.

Positive

• Launch of Clinical 360+ program to improve health access and outcomes
• Expansion of services to include specialty drug programs, at-home care management, and virtual clinical interventions
• Introduction of Sun Life Health 360 mobile app for comprehensive health management
• Targeting small-to-mid-sized self-insured employers, a growing market segment

Negative

• None.

Insights

Healthcare Industry Analyst

Clinical 360+ represents a significant innovation in the stop-loss insurance market, addressing critical pain points in healthcare access and cost management. This program could potentially reduce high-cost claims for self-insured employers by promoting early intervention and better health management. The focus on chronic conditions like kidney disease and heart failure is particularly noteworthy, as these often lead to expensive treatments.

The integration of specialty drug management is crucial, given the rising costs of injectable medications. By offering home infusion options, Sun Life may help reduce hospital-based infusion costs while improving patient convenience. The addition of musculoskeletal care is also strategic, as these conditions are common and can lead to significant productivity losses and treatment expenses if not managed properly.

While the program shows promise, its success will depend on member engagement and the effectiveness of the partnered health services. The impact on Sun Life's financials may take time to materialize, as health outcomes and cost savings typically have a lag effect. Investors should monitor adoption rates among Sun Life's client base and any early indicators of reduced claim costs or improved health outcomes in the coming quarters.

Health Tech Expert

Sun Life's Clinical 360+ program leverages several key health tech trends, positioning the company at the forefront of digital health innovation in the insurance sector. The mobile app integration is particularly noteworthy, as it creates a centralized platform for health management, which could significantly enhance user engagement and data collection capabilities.

The virtual clinical intervention for musculoskeletal conditions aligns with the growing telehealth market, potentially reducing the need for in-person visits and associated costs. The inclusion of mental health resources and wellness tracking features also taps into the burgeoning digital mental health space, which has seen increased demand and investment in recent years.

From a tech perspective, the success of this program will hinge on the seamless integration of various health services and data streams. If executed well, this could provide Sun Life with valuable health insights to further refine their risk assessment models and potentially develop new, data-driven insurance products. However, data privacy and security will be paramount and any breaches could pose significant reputational and financial risks.

– Clinical 360+ designed to improve health access and outcomes –

WELLESLEY, Mass., Sept. 23, 2024 /PRNewswire/ -- Sun Life U.S. today launched Clinical 360+, a stop-loss program that gives members access to personalized resources, tools and care services to help them better stay on top of their health. This new offering expands the company's original Clinical 360 program that uses data and clinical expertise to find cost savings and care services for stop-loss employer clients and their employees.

"Our Clinical 360+ program adopts a comprehensive strategy to increase early care intervention and connect members to care resources, giving them more control over their health," said Jennifer Collier, president, Health and Risk Solutions, Sun Life U.S. "Against the backdrop of high healthcare costs and inadequate access to services, finding suitable care can be stressful. Our new multipronged solution streamlines the process while positively affecting health outcomes for our members."    

Using insights from Sun Life's annual High-Cost Claims and Injectable Trends Analysis report, Clinical 360+ brings together care programs in one, easy app in collaboration with specialized health partners. This allows members and their dependents to directly interact with clinicians and resources tailored to their specific health needs, including:  

• A specialty and infusion drug program that provides members with their medications in a convenient and safe setting, including their own home.
• At-home kidney and heart care management programs that identify care opportunities for those with chronic or end-stage kidney disease or congestive heart failure.
• A musculoskeletal condition program providing virtual clinical intervention that is convenient and personalized for those facing back issues and other musculoskeletal conditions.
• Access to care advocacy and navigation via Sun Life Health Navigator, which provides members with clinical guidance and support to access appropriate care from qualified providers.
• Sun Life's newly launched mobile app, Sun Life Health 360, which connects all Clinical 360+ health programs and provides mental health resources, interactive tools, healthy habit tracking, fitness challenges, and a library of physician-reviewed health and wellness content.

Clinical 360+ is available to small-to-mid-sized self-insured employers that use a third-party administrator to manage their claims, billing, and plan designs.

Sun Life, the largest independent stop-loss provider in the U.S., covers high-dollar claims for self-insured customers who pay for the health services of their employees using their own funds rather than purchasing insurance. In 2023, the Kaiser Family Foundation's Health Benefits Survey found that 65% of covered employees in the country are enrolled in self-funded plans. 

About Sun Life
Sun Life is a leading international financial services organization providing asset management, wealth, insurance and health solutions to individual and institutional Clients. Sun Life has operations in a number of markets worldwide, including Canada, the United States, the United Kingdom, Ireland, Hong Kong, the Philippines, Japan, Indonesia, India, China, Australia, Singapore, Vietnam, Malaysia and Bermuda. As of June 30, 2024, Sun Life had total assets under management of C$1.46 trillion. For more information, please visit www.sunlife.com.

Sun Life Financial Inc. trades on the Toronto (TSX), New York (NYSE) and Philippine (PSE) stock exchanges under the ticker symbol SLF.

Sun Life U.S. is one of the largest providers of employee and government benefits, helping approximately 50 million Americans access the healthcare and coverage they need. Through employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. Sun Life employs more than 8,500 people in the U.S., including associates in our partner dental practices and affiliated companies in asset management. Group insurance policies are issued by Sun Life Assurance Company of Canada (Wellesley Hills, Mass.), except in New York, where policies are issued by Sun Life and Health Insurance Company (U.S.) (Lansing, Mich.). For more information visit our website and newsroom.

Media contacts
Anjie Coplin
Sun Life U.S.
Anjie.Coplin@sunlife.com

Connect with Sun Life U.S.
https://www.facebook.com/SLFUnitedStates 
https://www.linkedin.com/company/sun-life-financial 

 

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SOURCE Sun Life U.S.

FAQ

What is Sun Life's Clinical 360+ program and when was it launched?

Clinical 360+ is a stop-loss program launched by Sun Life U.S. on September 23, 2024. It provides members with personalized health resources, tools, and care services to improve health access and outcomes.

What services does Sun Life's Clinical 360+ program offer to members?

Clinical 360+ offers a specialty and infusion drug program, at-home kidney and heart care management, a musculoskeletal condition program, access to care advocacy and navigation, and the Sun Life Health 360 mobile app.

Who is eligible for Sun Life's Clinical 360+ program?

Clinical 360+ is available to small-to-mid-sized self-insured employers that use a third-party administrator to manage their claims, billing, and plan designs.

What percentage of covered employees are enrolled in self-funded plans according to the 2023 Kaiser Family Foundation survey?

According to the 2023 Kaiser Family Foundation Health Benefits Survey, 65% of covered employees in the United States are enrolled in self-funded plans.