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).

 

To print this article, click on the title and scroll to “PRINT THIS PAGE” at the bottom.

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.