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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Eradicating the Tapeworm: the new mission of Amazon/JP Morgan/Berkshire

Just like that, the healthcare industry is poised to change forever.

Three of the most eminent figureheads in American business — Jamie Dimon, Jeff Bezos, and Warren Buffett — have announced their intention to form a healthcare company. Whatever this new firm looks like, its impact is all but guaranteed to be massive.

In his statement about the new venture, Buffett had some choice words for the industry as a whole. “The ballooning costs of healthcare,” he said, “act as a hungry tapeworm on the American economy.” Read more »

Fox’s “The Resident” has ludicrous story lines, but poor performing surgeons are real

This week, The Resident premiered on FOX.  If you missed it, you should find a way to stream it.

It’s not just trashy, fun TV (although it definitely is that). The show also manages to skewer one of our pet peeve figures in healthcare — the overhyped surgeon.

Introducing: McDreamy

The Resident wastes no time in introducing us to its major villain, Dr. Randolph Bell. Read more »

Five Ways The Healthcare Industry Will (and Won’t) Change in 2018

In 2017, the healthcare industry in America held its breath, and braced for change.

Politically, it was the most bitterly contentious, suspenseful, erratic year for healthcare since the passage of the Affordable Care Act in 2010. Businesses across every sector felt the shocks. But for all the debate — policy stayed more or less the same.

That’s not to say, however, that change isn’t coming. Whether reacting to word from Washington, or innovating on their own terms, healthcare businesses are trying to anticipate what could happen next year. Read more »

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 »

These Dallas-Fort Worth Surgeons Perform Better than 90% of their Peers Nationwide

When you need surgery, it matters who performs the procedure.

Top-performing surgeons give you the best odds of a smooth surgery, with minimal complications and a short recovery time. Less skilled surgeons, on the other hand, are more likely to produce adverse outcomes. These can mean longer hospital stays, bigger bills, or even permanent disability or death.

Clearly, it’s worth your time to choose the best surgeon available. But finding high-performing surgeons has never been easy. Reliable outcomes data is hard to find, and even harder to interpret. We believe that should change, so we’ve done the work for you. 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 »

Secrets of a Top-Performer — Dr. Michael Haglund, Neurosurgeon

Dr. Michael Haglund, of Duke Health in North Carolina, recently appeared in The Raleigh News and Observer. The Observer story showed that Dr. Haglund earned an MPIRICA Quality Score of 720, for three spinal fusion procedures. This makes him the single-highest scoring provider of these procedures in the country.

This is an extraordinary achievement. We caught up with Dr. Haglund to see what insight he might have to offer. He shared what, in his view, contributes to his success. Read more »

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