OUR SOLUTION: Focus on Outcomes Using Proprietary Data
Rework is expensive in any business. It is extremely expensive in health care.
Insurance carriers put tremendous importance on their network of providers, even at the expense of their clients. Most insurance plans focus on networks and preferred providers, without much attention paid to the quality of the care offered by those providers. If outcomes were measured as most networks were developed, 20 to 30% of the providers in those networks would not be included because of quality issues. Unfortuantely, in the current system, how efficiently a provider offers care, and the number of complications that patients experience, are not a part of the equation. In the case of complications, the hospital, provider, or facility all get paid twice–so there is no inherent incentive for providers to offer the best possible care.
In innovative health care plans like ours, we use proprietary data to help your employees choose their providers. If you’re looking, for example, for someone to perform a total knee replacement, we can look at the physicians who perform those procedures in your area. Do you want the doctor who does the most number of cases per year? Not necessarily. We’ll guide you to the providers who are most qualified, experienced, and effective, with the best possible outcomes. When the focus switches from services rendered to positive outcomes, costs are lower and patient care is far better.