DENVER--(BUSINESS WIRE)--BridgeHealth, a leading provider of high-quality, lower-cost, bundled surgical case rate benefit plans, says research shows medical travel to surgical centers of excellence can increase cost savings for employers and improve care for employees in high-deductible health plans (HDHPs). The research appears in a published issue brief by BridgeHealth titled, “Why Employers Might Want to Rethink HDHPs.”
Acknowledging that HDHPs have driven health benefit savings for employers, the BridgeHealth brief presents worrisome findings that these savings come at the expense of workers’ health.
“Although HDHPs reduce utilization, workers forgo necessary as well as unnecessary care, according to several studies,” explained BridgeHealth CEO Mark Stadler. “Delayed care can resurface later as more costly health complications, emergency room visits, hospitalizations, readmissions, disability and absenteeism."
Especially concerning is that people in consumer-driven plans are more likely to forgo preventive services that carry no out-of-pocket cost – “essential health benefits” under the Affordable Care Act. Workers seem unaware that some preventive care is free to patients.
“What’s needed are innovative employee health benefits that drive even deeper savings while improving care for workers,” Stadler said. “Offered by specialized benefit management firms, medical travel to surgical centers of excellence can achieve both goals.”
But some medical travel plans are better than others, cautioned Stadler. The best benefit management firms identify top-performing hospitals and surgical centers – by practice, procedure and specific physician group – based on nationally recognized quality ratings. The firms then negotiate with these high-quality surgical teams for episode-of-care case rates, bundling the various charges for each surgery into a single discounted price. The benefit firms bring these discounted case rates to employers, charging a predetermined per-employee per-month access fee.
“The employee wins because he or she pays little or nothing for high-quality surgery under this arrangement,” Stadler said. “Financial hardship no longer is a reason to delay necessary care. The employer wins because it enjoys deep savings on high-quality surgeries for its employees and avoids costly postoperative complications.”
BridgeHealth’s research brief shows that for a variety of bundle-priced surgeries, an employer saved $3.1 million in four years. ROI for businesses has ranged from 2:1 to 16:1 based on the level of engagement that plan sponsors have chosen.
Founded in 2007, BridgeHealth (www.bridgehealth.com) is a surgical benefits management company that offers a suite of products for self-insured group health plans to improve quality and outcomes of surgery, reduce costs and positively affect the rate of unnecessary surgery. Through decision support, a high-quality narrow network, care coordination and other strategies, clients get real savings in cost and high-quality outcomes while providing an outstanding patient experience through a facilitated process. Clients achieve very quantifiable results for themselves and their employee/plan members in a manner that integrates with their full suite of health plan benefits. BridgeHealth is headquartered in Denver, Colo.