Healthcare Costs: Are You Paying for a Lexus and Getting a Pinto?

Inconsistent healthcare costs - are you paying for a Lexus but getting a Pinto?The rising cost of healthcare in this country has arguably reached a “state of emergency.” Over the last 15 years, employers and employees have faced rising insurance premiums and contributions that drastically outpace inflation. And it’s not as if you’re getting what you pay for.

Expensive Healthcare Can Cripple Organizations

The cost of healthcare benefits has become a serious burden, and as we noted in a previous blog, reducing the cost of healthcare continues to be the number one priority of HR benefit managers. But there’s more: beyond the absolute dollars of healthcare, there are opportunity costs that we don’t often think about. Money that would have otherwise gone into investments or infrastructure development is now being diverted to employee healthcare benefits, and that has implications for the long term viability of every organization.
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Lumpy Gravy: the Lack of Uniformity in Hospital Performance

lumpy-gravy-1050x800-mpiricaSince we’re embarking into the holiday season, let’s talk about gravy!

I don’t know about you, but when I think about gravy, I think of a golden liquid with smooth even consistency throughout. But as any cook knows, gravy is rarely uniform. While there are spots that are smooth and perfect, more often than not, there are plenty of lumps.

It’s exactly the same with hospitals.
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Happy But Dead: Why Outcomes-Based Quality Matters

patient satisfactionIn 2012, a shift in policy changed the world of healthcare quality transparency. The government implemented a rule in which Medicare reimbursement are now based in part on quality performance. Their determination of quality? Customer satisfaction.

Starting on October 1, 2012, 30% of the decision for Medicare reimbursement began to be determined by how well hospitals score on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, which is designed to measure patient satisfaction.

While well intended, a key issue was immediately raised: namely that there are compelling data showing patient satisfaction is NOT a good measure of outcome quality. In fact, a 2012 study by a team of researchers at UC Davis found that patient satisfaction is correlated with higher rate of DEATH and medical expenses. Read more »

Here’s why your employees may need better referral options for surgery

Better referral optionsYour employee gets the news: She’s put it off for more than six months, but she needs to have knee replacement surgery. So, she asks her primary care physician for a referral to an orthopedic surgeon.

Often, that referral will be based on a personal relationship – maybe it traces back to medical school or it’s because the two physicians play golf together. The point is, it’s often not based on the quality of the surgeon who will do the knee surgery, or the performance demonstrated by the hospital. Read more »

The true cost of low-quality surgery: It can be life and death

True costLow-quality surgeries can mean the difference between life and death. Even if it’s not about life hanging in the balance, low-quality surgeries can translate into additional time off and stress for employees. The answer? Help your employees make the right decision on the right surgeon from the very start. That’s healthcare transparency at its best.

Case in point: At least eight babies died after undergoing pediatric open heart surgery at Miami’s St. Mary’s Medical Center between December 2011 and December 2013, reported CNN on June 15. St. Mary’s Medical Center was able to keep its death rate under wraps. CNN had to do a formal records request with the state of Florida to determine that the hospital’s death rate for pediatric open heart surgeries was 12.5% — that’s more than three times the national average of 3.3%, according to the Society of Thoracic Surgeons. Read more »

We have good news and bad news

Good news and bad news16 years ago, a Wall Street Journal article reported that hospitals with great reputations aren’t necessarily the best.

In 1999, the article cited an Anthem Blue Cross Blue Shield study and revealed that a world-renowned heart surgery hospital in Ohio had far worse actual outcomes than a lesser-known hospital across the Southern state line in Kentucky. (As it happens, the study used the same methods that is behind the MPIRICA Quality Score.)

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