SURGERY BENEFIT MANAGEMENT Savings Example: 10,000 Members 31 Knee Replacements $350,000 31 Hip Replacements $275,000 32 Lumbar Spinal Fusions $515,000 21 Cervical Spinal Fusions $272,000 52 Hysterectomies $461,000 15 Cardio Bypasses $380,000 14 Bariatric Surgeries $122,000 TOTAL SAVINGS $ 2,375,000 (23%) “We have saved significant dollars on our surgeries, and our members have reacted extremely positively to the service being offered by our new surgery program. Not only is the company saving, but our members are savings thousands, as well as getting a financial reward via our Recovery Incentive! A few members have also benefited by avoiding some unnecessary surgeries and are doing great! Thanks for your help!- HR Director, Large Employer For more information on our surgery network or the many other cost containment solutions offered by Relevant Healthcare, please contact us at: WWW.RELEVANTHEALTHCARE.COM 855-328-5100 Surgery Up to 25% of all patients experience a complication from inpatient surgeries 30% of all indicated surgeries are medically UN-necessary. From 2001 to 2011, nearly 6,000 doctors had their clinical privileges restricted or taken away Patient “Shared Decision Making” results in 20+% reduction in costs “Improving Quality, Reducing Costs” Advantages of a High Performance Network Case Rate Pricing: pre-determined, bundled price on an episode of surgical care—physician, facility, anesthesia, and device costs. Better Outcomes—stringent credentialing standards. All providers in Top 25% in the US Reduced complications, less recovery time and revision rates Increased Member Engagement and Price Transparency What makes Relevant’s Surgery Network Different? Includes a National High Performance Network of the top 25% providers based on clinical outcomes. Concierge Member Care Coordination guides members through the entire process, answering questions and solving problems Direct Member out of pocket savings—member incentives are implemented to drive increase penetration into the program. Even after incentives (waiving copays/deductibles + cash incentives), Plans save 25%. Predictive Modeling and Shared Decision Support offers patients and employers the information needed to investigate alternatives, avoid un-necessary surgeries, engage members to utilize the program, and save significant dollars.

Relevant Healthcare - Surgery Benefit

Download PDF Report

Upload
scott-fuqua
View
99
Download
2

Embed Size (px)

Citation preview

Page 1: Relevant Healthcare - Surgery Benefit

SURGERY BENEFIT MANAGEMENT

Savings Example: 10,000 Members

31 Knee Replacements $350,000

31 Hip Replacements $275,000

32 Lumbar Spinal Fusions $515,000

21 Cervical Spinal Fusions $272,000

52 Hysterectomies $461,000

15 Cardio Bypasses $380,000

14 Bariatric Surgeries $122,000

TOTAL SAVINGS $ 2,375,000 (23%)

“We have saved significant dollars on our

surgeries, and our members have

reacted extremely positively to the

service being offered by our new surgery

program. Not only is the company

saving, but our members are savings

thousands, as well as getting a financial

reward via our Recovery Incentive! A

few members have also benefited by

avoiding some unnecessary surgeries

and are doing great! Thanks for your

help!- HR Director, Large Employer

For more information on our surgery network or the many other cost containment solutions offered by Relevant Healthcare, please contact us at:

WWW.RELEVANTHEALTHCARE.COM 855-328-5100

Surgery

Up to 25% of all patients

experience a complication from

inpatient surgeries

30% of all indicated surgeries are

medically UN-necessary.

From 2001 to 2011, nearly 6,000

doctors had their clinical privileges

restricted or taken away

Patient “Shared Decision Making”

results in 20+% reduction in costs

“Improving Quality, Reducing Costs”

Advantages of a High Performance Network

Case Rate Pricing: pre-determined, bundled price on an

episode of surgical care—physician, facility, anesthesia,

and device costs.

Better Outcomes—stringent credentialing standards. All

providers in Top 25% in the US

Reduced complications, less recovery time and revision

rates

Increased Member Engagement and Price Transparency

What makes Relevant’s Surgery Network Different?

Includes a National High Performance Network of the top 25% providers based on clinical outcomes.

Concierge Member Care Coordination guides members through the entire process, answering questions and solving problems

Direct Member out of pocket savings—member incentives are implemented to drive increase penetration into the program. Even after incentives (waiving copays/deductibles + cash incentives), Plans save 25%.

Predictive Modeling and Shared Decision Support offers patients and employers the information needed to investigate alternatives, avoid un-necessary surgeries, engage members to utilize the program, and save significant dollars.