3 steps to make benefits consulting easier – through data solutions

According to a survey from DirectPath, 83% of benefits brokers say their job is harder today than it was three years ago. The surprising thing about that number? It implies that only 17% of brokers believe their job is easier today.

We side with the majority on this one. Benefits brokers have never had it harder. In the face of soaring health care costs, companies are demanding benefits brilliance. They want to see smart strategies on a shoestring budget. And if you can’t deliver, your competition will.

To thrive in this environment, brokers need to stand out from the crowd. One way to do that is to bring cutting-edge data strategy to your benefits consulting.

There are a number of data analytics solutions on the market today. However, you can’t just bring your client a goody-bag of random products. You need to tailor your selections to your client’s strategy. Read more »

Your Employee Surgery Roadmap [Infographic]

When your employees need surgery, the way to safe, effective care is fraught with obstacles. Surgeons push for care that patients don’t need; it’s extremely difficult to find high-quality providers; and hospital systems charge rates far out of proportion with their value.We know that care decisions can be trying, and we’re here to help. Let the roadmap below be your guide to avoiding these surgical quality pitfalls. It’s the best way to secure the right care for your employees, from the right provider, at the right value. Read more »

How Employers Can Stop Unnecessary Surgery [Whitepaper]

Self-insured employers: how many of your employees get surgeries they don’t need? Evidence suggests the number might be higher than you think.

Physicians say that as much as 11.1% of all surgical procedures are given inappropriately.

Each year, 500,000 patients get heart stents, and 700,000 patients get meniscus knee surgeries that show next to no clinical benefits.

Aside from the risks these unneeded procedures pose to patients, they also come at outrageous prices. The annual cost of unnecessary surgery for every 1,000 employees in your company — about $250,000.

Clearly, inappropriate surgeries are a problem you can’t afford to ignore. But what can your company do about them?

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6 Reasons Why Patient Survey Data Doesn’t Tell the True Story

Perceptions of patients have changed. They’re not just “patients” anymore — they’re also “customers.”

And that small semantic difference has big implications for the healthcare industry. One of them is the abundant use of customer-satisfaction surveys.

Enshrined into official healthcare policy in 2010, patient satisfaction now carries serious implications for providers. Hospitals that fail to sufficiently satisfy their patients see significant cuts in their reimbursement for Medicare and Medicaid services. Read more »

The Next Big Innovation in Health Benefits Design: “Surgeons of Excellence”

On its surface, ‘Centers of Excellence’ looks like an intelligent strategy.

Self-insured employers, pursuing cost-efficiencies and streamlined care for employees, select certain hospitals to become provider-partners. They label these partners ‘Centers of Excellence’, and design their benefits packages around them.

But this model only works if employers rigorously scrutinize the provider’s quality of care. Unfortunately, their due diligence sometimes falls short. MPIRICA’s analysis has found that employers frequently select hospitals that may not have the strongest track record for surgical success.

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How Much Can Selecting The Wrong ‘Center of Excellence’ Cost You?

The term “Center of Excellence” (CoE)  is a powerful distinction. Self-insured employers have begun to apply this label to hospitals they partner with to deliver high-ticket, high-volume surgeries — like total knee replacements — to their employees.

For employers, the bundled pricing that CoEs offer (in exchange for a volume of patients) is an attractive prospect. But for the employees, the label means much more.

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Employees Wary of Narrow Networks? Here’s How to Win Them Over

Note: This post, from MPIRICA CEO Shakil Haroon, originally appeared at BenefitsPRO.

Narrow networks might have been born in the 90s, but they came of age in the last five years.

Recent surges in care costs, plus the effects of the Affordable Care Act, have made these plans more attractive to payers. By funneling patients toward a relatively small range of providers, narrow networks help insurers contain costs and improve outcomes. Read more »

Do You Know How Good Your Doctor (Surgeon) Is? [Infographic]

Today, when healthcare consumers who need surgery start their research of potential hospitals or surgeons, they are bombarded with confusing amounts of ratings, “best of” lists, and hoards of big data. When it comes to patient reviews, can you trust an anonymous Yelper to guide you to a quality surgeon? And when you come across websites with a ton of data like complication rates, volumes, mortality, or readmissions, how do you make appropriate conclusions about the risks you potentially face when you choose your healthcare provider? Read more »

What is an acceptable number of deaths from medical errors… for your family?

accept ZERO medical errorsIn healthcare, death goes by another name – mortality.  It’s as if our industry believes using another term lessens the permanent and devastating loss people feel over the death of a loved one. For these people, questions of “how” and “why” will linger for years, and for some, not a day will pass without thoughts of “what might have been” or “if only…”

As to the “how,” for over a quarter of a million families each year, the answer is excruciating: medical error. That’s the heartbreaking finding by Johns Hopkins researchers, published last week in the British Medical Journal, and covered by nearly every major news outlet, including US News and World Report, Washington Post, and NPR. Read more »

Into the New Frontier of Outpatient Surgery Quality

The new frontier of outpatient surgery quality

I’m pleased to bring you news about an exciting development for our company and the MPIRICA Quality Score: we are expanding to include outpatient surgeries!

According to the National Center for Health Statistics, 35 million procedures are performed in outpatient settings annually. When most people think of “outpatient,” the procedures that typically come to mind are sports related injuries like knee meniscus or shoulder rotator-cuff repair. However, the reality is that even advanced surgeries have moved out of inpatient settings. In fact, Blue Cross Blue Shield recently reported that 82% of spine surgeries are now performed in an outpatient setting. Unfortunately for patients wondering about the quality of outcomes from outpatient surgeons or facilities, there is nowhere to turn because the data simply does not exist. Read more »

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