How ChristianaCare Built a Blueprint for Better Caregiver Health and Lower Costs

By Donna Antenucci, MHA, BSN, RN, and Emily Sahm, EA  Note: This article first appeared in the March/April issue of the Delaware State Chamber of Commerce's Delaware Business Magazine. We know rising health care costs can feel overwhelming for both employers and employees. As Delaware’s largest private employer — with nearly 23,000 employees, spouses and dependents enrolled in our self-funded health plan — ChristianaCare faces these challenges every day. That’s why we’re committed to finding smart, innovative solutions that improve employee health while keeping costs in check. We don’t stop there — ChristianaCare partners with businesses that have an interest in providing high-quality health care for their employees while keeping costs manageable.

The key to a healthier, more resilient workforce is tackling health issues early in order to prevent the need for costly emergency or “rescue” care. By prioritizing prevention and early intervention, we’ve made progress in improving employee health while controlling costs. In 2023, inpatient facility costs for our employees — which include hospital admissions for surgeries, medical treatments and other care requiring overnight stays — dropped by 9%. Wellness incentives and chronic disease management that shifted care to more cost-effective outpatient settings are driving these results. One of ChristianaCare’s differentiators is CareVio^®, our care coordination and chronic disease management platform.

CareVio provides personalized support to help employees and their families manage conditions and stay on track with preventive care. CareVio’s diabetes program, for example, has delivered remarkable results. Nearly all participants improved their blood sugar levels in 2023, with average A1c reductions of 1.7 points.

We’ve also focused on encouraging primary care visits through collaboration between our Population Health and Total Rewards teams. Together, we designed a voluntary wellness incentive program that rewards employees and their families for healthy choices, including support for tobacco-cessation programs to help employees quit smoking and lead healthier lives. In 2023, we expanded our wellness incentive program to include primary care visits for employees and their spouses. Over the next eighteen months, primary care utilization increased over 10%, rising from 66% to 77% as of January 2025. Employees who stay connected to primary care catch health problems early and build stronger relationships with their doctors. We’ve launched programs targeting specific health needs. Our breast cancer screening initiative, focused on women ages 52 to 74, increased participation rates from 63% to 72% in 2023, exceeding our target. Additionally, the CareVio metabolic health program is helping a growing number of participants manage complex conditions with tailored support. Flexibility is essential. That’s why we created the Center for Virtual Health, which provides virtual-first primary care to more than 1,200 employees. This program makes high-quality, preventive care more accessible. Employees can fit care into their schedules while maintaining consistent support for their health.

We encourage employees to stay up to date on immunizations by offering frequent vaccination events and tying participation to eligibility for the Caregiver Rewards Program payout. By making it easy and rewarding to stay protected, we’re fostering a safer, healthier workplace for everyone.

In January 2023, we announced the ChristianaCare Clinical Alliance, a new clinically integrated network in partnership with Highmark. Implemented in our employee health plan in July 2024, the network connects ChristianaCare-employed and community clinicians to provide evidence-based, coordinated care. Focused on improving wellness and managing chronic conditions, the Clinical Alliance is helping caregivers and their families stay healthier while reducing costly emergency visits and hospital stays. Employees who choose Clinical Alliance providers also enjoy lower deductibles for their care. Through all these initiatives, we are making a meaningful difference for our caregivers and our costs. In 2023, thanks to our focus on prevention and smarter care delivery, we kept our overall health care cost growth below the national average. Healthier employees lead to lower expenses and a more engaged, productive workforce. By showing that we value employee health, we’re creating a stronger, more resilient workplace.