- Complex Case Management
- Inpatient Management
- Outpatient Management
- Telehealth Services
- Nurse Health Coaching
- Maternity Management
- Behavioral Health
It is possible to save on health care costs. Here’s how.
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.
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 firstname.lastname@example.org.
 “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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Every day, headlines detail the casualties of the nation’s surge in heroin and prescription painkiller abuse: the funerals, the broken families and the patients cycling in and out of treatment. Now, a new study sheds light on another repercussion — how this public health problem is adding to the nation’s ballooning health care costs and who’s shouldering that burden.
The research comes as policymakers grapple with how to curb the increased abuse of these drugs, known as opioids. State legislators in New York,Connecticut, Alaska and Pennsylvania have tried to take action by adding new resources to boost prevention and treatment. In addition, President Barack Obama laid out strategies last month intended to improve how the health system deals with addiction.
Published Monday in the journal Health Affairs, the study measures how many people were hospitalized between 2002 and 2012 because they were abusing heroin or prescription painkillers, and how many of them got serious infections related to their drug use. It also tracks what hospitals charged to treat those patients and how the hospitals were paid.
Lowe’s home improvement company, like a growing number of large companies nationwide, offers its employees an eye-catching benefit: certain major surgeries at prestigious hospitals at no cost to the employee.
How do these firms do it? With “bundled payments,” a way of paying that’s gaining steam across the health care industry, and that Medicare is now adopting for hip and knee replacements in 67 metropolitan areas, including New York, Miami and Denver.
Here’s how it works: Lowe’s and other employers pay one flat rate for a particular procedure from any of a number of hospitals they’ve selected for quality, even if they are a plane ride away. And, under the agreement, the hospital handles all the treatment within a certain time frame — the surgery, the physical therapy and any complications that arise — all for that one price.
(Kaiser Health News, Michael Tomsic, WFAE, April 22, 2016)
Which medical facility do you choose when you have the flu? A sprained ankle? Headaches? Your health plan may now include telemedicine—video or phone conferences with a board-certified doctor, within minutes of a call. You may be able to save the costs of Emergency Room (ER) or Urgent Care visits for a wide variety of common ailments (see “Treatment Alternatives” below).
A Truven Health Analytics’ study reported that 71% of ER visits are unnecessary.[i] Urgent care facilities now treat a number of minor illnesses and ailments. And the rapidly growing use of telemedicine means that even remote rural areas can get expert consultations with board-certified physicians.
Compare these costs from the study:
|Average ER Visit||Average Primary Care Doctor Visit||Average Telemed Consultation*|
*Consult your summary plan description for complete coverage details
Need a better prescription for your health care expenses? The expert care of local physicians may be available with a phone call, no matter where you are.
TREATMENT ALTERNATIVES TO THE EMERGENCY ROOM
[i] Sabrina Rodak, “Study: 71% of ED Visits Unnecessary, Avoidable,” Becker’s Hospital Review, April 25, 2013, http://www.beckershospitalreview.com/capacity-management/study-71-of-ed-visits-unnecessary-avoidable.html (accessed February 23, 2016)