7 Care Management Results: Balancing Medical Care, Benefit Costs

How Can Employers Balance Medical Care & Benefit Costs?

MedCost Care Management programs are designed to conserve health care costs for our clients while improving an individual’s health.

Our nursing staff averages 22 years of experience; and includes board-certified case managers and nurses certified in intrinsic coaching and grief counseling.

Here are our 2017 results that exceed industry averages, resulting in lower health care costs for our clients.

Care Management

Care Management Resources

Want to know more about how to manage medical costs? These resources give employers more details:

  1. Complex Case Management 
  2. Inpatient Management
  3. Outpatient Management
  4. Telehealth Services
  5. Nurse Health Coaching
  6. Maternity Management
  7. Behavioral Health

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How to Help Employees Become HEALTHY & WHOLE (Video)

Ready to Balance the Care of Your Employees
with the Financial Health of Your Company?
HEALTHY & WHOLE

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  • Annual health care costs in America are $3.2 trillion.
  • Employees average 5.3 unplanned sick days per year.
  • That productivity lost is more than 1 and 1/2 hours of an 8-hour day.

When disease management and wellness programs combine, employers average $30 per member per month in decreased health care costs.

HEALTHY & WHOLE

That’s why we’ve developed a comprehensive program called HEALTHY & WHOLE.

HEALTHY & WHOLE encompasses physical, emotional, financial and social health – and
greater job satisfaction for employees.

The goal is to help employers balance the care of employees with the financial health of your
company.

HEALTHY & WHOLE Includes Disease Management

Our nurse health coaches provide hands-on support, helping members reduce blood
pressure, glucose levels and lose weight.

And for complex conditions, case managers provide expert help for families in very difficult
situations.

Over 73% of businesses offer corporate wellness to attract and retain talent, and strengthen
company culture. Another advantage is to encourage enrollment in consumer-directed health
plans, a growing trend.

HEALTHY & WHOLE Supports Lifestyle Changes

HEALTHY & WHOLE addresses not only members with chronic diseases, but the 75% who
need support with lifestyle changes.

Lifestyle changes – even small ones – create measurable outcomes of better health, productivity and bottom line.

The Results of Corporate Wellness Programs

HEALTHY & WHOLE

http://www.nahueducationfoundation.org/materials/WellnessBrochure.pdf

Implementing corporate wellness programs dropped claims costs -28%, doctor visits -17% and hospital admissions -63%.

This same study showed disability costs down -34% and injury incidence down -25%.

An employer we worked with said that he is passionate about having happy employees. If they
are happy, they will be productive and engaged.

A Program That Benefits Employees and Companies

Lifestyle coaching. Financial education. Fitness. Nurse health coaching. Long-term medical
conditions. HEALTHY & WHOLE serves everyone’s needs, including your company’s.

We want to see everyone HEALTHY & WHOLE. That’s why it’s important to us to balance the care of your employees with the financial health of your company.MedCost

HEALTHY & WHOLE

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(This post is a transcript from the video, “MedCost HEALTHY & WHOLE.”)

For more information on wellness consultations for employers, email Kati Davis.

 

Study: 30% of Children’s Hospital Readmissions May Be Preventable

childrens hospital readmissionsOne of the key indicators of the quality of a hospital’s care is how frequently its patients are readmitted within a month after being discharged.

A study this month examined readmission rates for pediatric patients and found that nearly 30% of them may have been preventable.

The study, published online by the journal Pediatrics, reviewed the medical records and conducted interviews with clinicians and parents of 305 children who were readmitted within 30 days to Boston Children’s Hospital between December 2012 and February 2013.

It excluded planned readmissions such as those for chemotherapy. Overall, 6.5% of patients were readmitted during the study period.

The study found that 29.5% of the pediatric readmissions were potentially preventable. In more than childrens hospital readmissionsthree-quarters of those cases, researchers determined that hospital-related factors played a role. A significantly smaller proportion were related to the patient (39.2%), often because of issues that arose after discharge, or the primary care physician (14.5%). (Multiple factors played a role in some patients’ readmissions, so the total exceeds 100%.)

The most common hospital-related reasons had to do with how patients are assessed, postoperative complications or hospital-acquired conditions.

(Kaiser Health NewsMichelle Andrews July 29, 2016)

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Saving Health Costs: A Case Study

It is possible to save on health care costs. Here’s how.

savings hospital admissions health costs

Between 1999 and 2015, employer-sponsored health premiums rose 203%.i Deductibles for workers have mushroomed faster than both income and premiums. Businesses have struggled to find ways to contain these costs while providing for their employees.

This graph, “Health Plan Savings for One Employer,” is a real-life illustration of how wise management based on data analysis has saved millions of dollars for a MedCost client over the past five years.

When this client came to MedCost in 2010, hospital admissions were 87 per 1,000 covered lives. Without any changes in plan design or benefits, the MedCost clinical team ensured that patients received thorough follow-up care to avoid readmissions after joint replacements, cardiac and back surgeries and other procedures.

Skilled nurse managers helped schedule doctor visits and asked questions such as: “Are you taking all your meds? Is there anything you don’t understand about your care?”pregnancy, pregnancies, high risk pregnancy, health costs

Board-certified case managers and highly specialized obstetrical nurses focused on early identification of high-risk pregnancies, offering tips for prenatal care. Sometimes they interacted with doctors’ offices to help families get the answers they needed.

MedCost nurse health coaches worked with patients suffering chronic conditions such as high blood pressure, diabetes, migraines or congestive heart failure, helping them reduce symptoms, close gaps in care and comply with treatment plans.

The result? Better health for patients, and increasingly lower costs for employers. Since 2011, this employer has enjoyed five consecutive years under budget for health plan expenditures—as a result of data analysis and managing the right care at the right time through MedCost Care Management programs.

It is possible to save on health care expenses, using the right partner to manage employee health effectively. If you would like more information about this case study, please contact Jason Clarke at jclarke@medcost.com.

 

[1] “Recent Trends in Employer-Sponsored Health Insurance Premiums,” Kaiser Family Foundation, January 5, 2016, http://kff.org/infographic/visualizing-health-policy-recent-trends-in-employer-sponsored-health-insurance-premiums/ (accessed June 16, 2016).

 

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Facing Life’s Biggest Challenges

Margaret Nunez image

Three and a half years ago, Margaret Nunez first experienced MedCost’s Complex Case Management program when she was diagnosed with Multiple Myeloma, a type of cancer that causes abnormal plasma cells to accumulate in bone marrow and interfere with the production of normal blood cells. The disease is considered incurable but treatable.

Margaret received radiation and chemotherapy and responded well to the treatment. She also underwent a successful auto stem cell transplant. Several months later, with her condition stable, Margaret’s case management file was closed.

When later tests indicated an increase in Myeloma markers, her case management file was re-opened. While participating in the program this second time, Margaret was diagnosed with breast cancer and underwent surgery, followed by radiation. During breast cancer treatment, her Myeloma maintenance therapy was discontinued. Once the breast cancer treatments were over, she restarted maintenance therapy. Since her condition was stable, her case management file was closed once again.

Several months later, Margaret re-joined the program after a brief hospital admission for neutropenic fever. Neutropenia is an abnormally low count of white blood cells and makes an individual vulnerable to infection. Margaret’s next bone marrow biopsy showed persistent Myeloma.

“Having the same person follow my case from before my stem cell transplant and then periodically since then has been so important. I’ve been through so many changes and my case manager is always there for me.”*

The goal of our Complex Case Management is to ensure the best use of available health plan resources, while enhancing quality of life. For more information, visit our Case Management page or contact Jason at MedCost.

*Margaret Nunez gave MedCost permission to share her story to help others realize the benefits of the Complex Care Management program.