And that did make sense at the time (and still is a BIG part of the story).
Because utilization is where value is actually delievered. If nobody uses a program, it doesn’t matter how good it is on paper. So we’ve spent a lot of time showing how engagement drives outcomes… and how well we perform in that area.
But recently, something just as important came into focus. The other side of the coin, if you will…
The fundamental understanding of why utilization matters in the first place. Because utilization only matters if there is a tangible financial savings when the program is used.
And the more real and defensible those savings are… the more valuable utilization becomes.
That realization led us to do something we probably should have done at this level a long time ago. We stepped back and built the most balanced and disciplined financial foundation we’ve ever had across our four core services:
Not to change the conversation.
But to strengthen it.
We wanted to clearly demonstrate how each service produces real savings… using peer-reviewed research, claims analyses, and real-world validation… so that when we talk about utilization, we’re talking about scaling proven economics.
Because once that foundation is established, something interesting happens.
Utilization stops being theoretical. It becomes mechanical.
And that’s where we’ve always excelled.
Before talking about engagement, we wanted to answer a simpler question:
Does each service produce measurable savings when used?
And just as importantly: At what point does it pay for itself?
Using conservative assumptions across a 100-life employer group, here’s what that looks like.
Breakeven utilization: 14.4%
Most employee populations see 30–50% of individuals needing care for acute, non-emergent issues annually. When virtual care substitutes even a portion of urgent care or ER visits, the math moves quickly.
Using the commonly accepted $500 avoided cost per episode, about 14–15 employees using the service annually covers the program cost.
That’s well within normal annual care demand.
Breakeven engagement: 5.6%
Roughly 1 in 4 adults experiences a behavioral health need each year. When those needs are addressed early, downstream medical costs often compress.
Using ~$1,070 lower annual medical spend per engaged participant, just five to six engaged employees in a 100-life group reaches breakeven.
Again… below the likely need.
Breakeven engagement: 6.7%
Chronic conditions drive most healthcare spending. Even modest stabilization can create measurable downstream savings.
At a conservative $900 per engaged member annually, about seven employees engaging reaches breakeven.
A threshold. Not a stretch.
Breakeven engagement: 1.8%
MSK issues are episodic but expensive. Imaging, injections, and surgery escalate quickly.
At roughly $2,000 in avoided annual costs per treated member, just two employees engaging meaningfully covers the cost.
A very low hurdle.
These numbers aren’t aggressive assumptions… they’re conservative thresholds.
And once those thresholds are established, the conversation changes.
From “does this save money?”
To “how much return can we generate by driving engagement??
IMHO… that’s a much more interesting discussion!
Let’s assume the following realistic engagement levels:
Total annual investment (100 lives):
~$22,800
Modeled medical costs avoided:
~$41,000
Net savings:
~$18,000
Portfolio ROI:
~80%
And that’s using conservative assumptions.
Notice something important here.
Virtual Primary Care at 5% is slightly below standalone breakeven. And yet the overall portfolio still produces a strong return.
Because this isn’t about individual services… it’s about building systems of health and wellness.
When you look at these services individually, you can miss the bigger picture of how they work in combination
Each one does something different. Together, they change the performance of the entire population.
That’s why we don’t think of virtual care as an add-on benefit. We think of it as the first layer of the benefits stack.
Handle frequent needs first.
Stabilize chronic risk.
Prevent avoidable events.
Let traditional coverage focus on catastrophic risk.
When viewed this way, ROI becomes much easier to understand.
Once the financial foundation is clear, utilization becomes more important than ever. Because now you know each interaction has real economic value.
Utilization doesn’t create ROI. It scales it!
And that’s where our long-standing focus on engagement and activation becomes a real differentiator. Because once the savings mechanics are proven, the conversation becomes operational:
How do we remove friction?
How do we communicate effectively?
How do we make access simple?
How do we reinforce usage?
That’s where value actually gets realized.
And again… that’s where we’ve always excelled.
Medical savings are only part of the story. Access to care also impacts workforce economics.
Using conservative assumptions in that same 100-life group:
Illustrative workforce impact:
Additional economic impact:
~$17,000–$31,000
And remember… this isn’t included in the original medical ROI.
So when combined, the financial impact of our program becomes even more compelling.
We haven’t changed how we think about utilization.
We’ve strengthened the financial foundation underneath it.
Because once you clearly establish that each service produces real savings, utilization stops being a question of if value exists.
It becomes a question of how much value you can generate.
Virtual care ROI doesn’t start with utilization.
It starts with validated economics.
Utilization just determines how far you can amplify the savings.
And once you look at it that way, the entire conversation changes.
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How to Design the Right Level of Support for Cost, Access, and Impact Rather watch than read?👉 Watch the short video walkthrough here. And scroll to the end for our...
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TL;DR Summary Most benefits conversations are inherently zero-sum… when one department wins, another absorbs the tradeoff. Modern buying committees have made benefits decisions more complex, political, and harder to align....
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