Development and Implementation of a Health and Well-being Index to Inform Risk Management and Patient Engagement in a Colombian Health Insurance Plan
Author(s)
Susana Orrego, MD, MMSc1, Paula Andrea Giraldo Pedroza, Statistician,2, Liliana Maria Patiño Restrepo, , Psychologist, MEd3.
1Seguros de Vida Suramericana SA, Medellin, Colombia, 2Seguros de Vida Suramericana, Medellin, Colombia, 3ARL SURA, Medellin, Colombia.
1Seguros de Vida Suramericana SA, Medellin, Colombia, 2Seguros de Vida Suramericana, Medellin, Colombia, 3ARL SURA, Medellin, Colombia.
OBJECTIVES: To develop and apply a scalable, data-driven Health and Wellbeing Index capable of assessing individual and population-level lifestyle behaviors, guiding personalized wellness interventions, and improving health outcomes and cost management in a Colombian health insurance setting.
METHODS: In 2022, a Health and Wellbeing Index was designed to evaluate habits across four domains: nutrition, physical activity, mental health, and financial health. The index integrates 13 predictive models and over 120 variables to generate a score from 0 to 100. Based on this score, individuals are classified into three categories: accompanied (requiring intensive follow-up), intermediate (with partial development of healthy habits), and self-managed (with strong, self-sustained habits). Personalized plans are generated based on individual needs. In 2023, a prospective risk model was developed to evaluate the relationship between index scores and health outcomes—claims, workplace accidents, occupational illness, and mortality—using data from 5 million insured individuals. The model incorporated modifiable and non-modifiable risk factors.
RESULTS: The integration of lifestyle data into actuarial models enabled early identification of high-risk individuals and supported more effective interventions at both payer and employer levels. Companies received sector-specific recommendations based on employee clusters. Among private health plan members, improved management of non-communicable diseases and reduced healthcare costs were observed. The model showed high predictive accuracy for occupational accidents and absenteeism among workers. Additionally, patients became more engaged in their health through increased awareness and tailored support.
CONCLUSIONS: The Health and Wellbeing Index proved to be an effective tool for promoting proactive health management. It supported better clinical, financial, and occupational decision-making for patients, insurers, employers, and public health entities. This approach aligns with Colombia’s national health priorities by enhancing prevention, personalization, and population health monitoring.
METHODS: In 2022, a Health and Wellbeing Index was designed to evaluate habits across four domains: nutrition, physical activity, mental health, and financial health. The index integrates 13 predictive models and over 120 variables to generate a score from 0 to 100. Based on this score, individuals are classified into three categories: accompanied (requiring intensive follow-up), intermediate (with partial development of healthy habits), and self-managed (with strong, self-sustained habits). Personalized plans are generated based on individual needs. In 2023, a prospective risk model was developed to evaluate the relationship between index scores and health outcomes—claims, workplace accidents, occupational illness, and mortality—using data from 5 million insured individuals. The model incorporated modifiable and non-modifiable risk factors.
RESULTS: The integration of lifestyle data into actuarial models enabled early identification of high-risk individuals and supported more effective interventions at both payer and employer levels. Companies received sector-specific recommendations based on employee clusters. Among private health plan members, improved management of non-communicable diseases and reduced healthcare costs were observed. The model showed high predictive accuracy for occupational accidents and absenteeism among workers. Additionally, patients became more engaged in their health through increased awareness and tailored support.
CONCLUSIONS: The Health and Wellbeing Index proved to be an effective tool for promoting proactive health management. It supported better clinical, financial, and occupational decision-making for patients, insurers, employers, and public health entities. This approach aligns with Colombia’s national health priorities by enhancing prevention, personalization, and population health monitoring.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
RWD61
Topic
Methodological & Statistical Research, Patient-Centered Research, Real World Data & Information Systems
Topic Subcategory
Health & Insurance Records Systems
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory), Diabetes/Endocrine/Metabolic Disorders (including obesity), Mental Health (including addition), Musculoskeletal Disorders (Arthritis, Bone Disorders, Osteoporosis, Other Musculoskeletal), Personalized & Precision Medicine