BH Introduction
7
Proactively managing surgery costs through patient engagement, shared decision-making, and a focus on quality.
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Transcript of BH Introduction
Proactively managing surgery costs through patient
engagement, shared decision-making, and a focus on quality.
“Clinical evidence shows that many patients undergo surgery that they
would decline if fully informed and shared decision-making can satisfy
physicians’ ethical obligations and reduce unwanted procedures”.
American Society of Law, Medicine & Ethics
“Although patients always have the right to participate in decisions about
their medical treatment, using formal shared decision-making processes
can be especially useful in cases where more than one treatment option
is available, and no treatment is considered ‘best’ according to clinical
evidence.
Report of the Council on Medical service. CMS report. American Medical Association.
The Business Issue
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Lack of Shared Decision-Making on Surgical Procedures
Proactive Surgery Benefit Management
An opportunity exists to achieve better outcomes and lower costs
by proactively engaging plan members in their treatment decisions.
Independent research shows that as much as 30% of major
surgical procedures are unnecessary and could be avoided or
handled in less invasive and less costly ways.
Additional studies show as much as a 20% reduction in costs
when utilizing “shared decision making” leading to less invasive
and less expensive alternatives to major surgery.
The Opportunity
3
BridgeHealth SBMTM consists of three integrated components:
BridgeHealth Early Indicators™ - identifying major surgical claims early in the process, when there is an opportunity to intervene.
BridgeHealth Engagement™ - providing medical education, resources and support related to treatment options and alternatives.
BridgeHealth SurgeryPath™ – providing access to providers offering the optimal combination of quality and value.
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Early
Identification
Member
Engagement
Quality Network
Access
The Solution
BridgeHealth Surgery Benefit Management
Savings are generated two ways:
By avoiding unnecessary surgeries…
when the Plan Member, after learning about treatment
options, avoids an unnecessary surgery or chooses a less
invasive, less costly, but equally effective alternative
treatment.
By utilizing the highest quality providers…
when the Plan Member, after learning about the importance
of quality, chooses an alternative provider for their surgery.
Savings from BridgeHealth SBMTM
Proactive Surgery Benefit Management
Engage
Educate
Empower
Higher quality outcomes
“People do not realize that their clinician does not always fully understand
their preferences and values. When this happens, the clinician’s treatment
recommendations may be different from what their patients would have
chosen had they been give the opportunity to be fully informed”. Dartmouth Atlas Report
2010
6
Gordon Larson
CMO/Executive Vice President
BridgeHealth Medical, Inc.
630-841-7566 Direct
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Contact us for a free analysis of the savings a
BridgeHealth SBMTM program could offer…
