Health plans, employers and members are experiencing unexpected and very unpleasant surprises following certain complex surgical procedures, usually spine-related. The surprises are coming in the way of bills for intraoperative neurologic monitoring (IONM)—and can sometimes reach into six figures!
During IONM, a technician or physician observes neural structures, such as nerves, the spinal cord and parts of the brain, to identify issues that could damage the nervous system. By noting any potential for damage in real time, corrective action can be taken during surgery.
When an employee of Hill Country Memorial Hospital developed chronic kidney disease, the not-for-profit hospital in Fredericksburg, Texas faced a whopping bill. Not only was an employee facing a lifetime of dialysis treatments three times a week, missed work hours and increased medical care, the 80-bed hospital had maxed out its $1 million premium for its employee health plan.
“It cost us quite a bit,” recalls Becky Laughlin, the current benefits manager, who was the benefits coordinator at Hill Country Memorial Hospital when the incident occurred.
After the episode, the HR and benefits team looked for a solution. They found one in data management provider Advanced Plan for Health, which oversees its employee medical care expenses generated by its third-party employee benefit administrator Web TPA. Using its Poindexter program, APH oversees the hospital’s employee medical expenses, looks for patterns of cost overruns, pharmaceutical pricing and possible drug seeking behavior, overuse of emergency room and urgent care facilities. It generates reports that are sent to employers on a weekly, monthly or quarterly basis.
Chronic kidney disease is a health crisis that affects employer and employees—and it continues to increase. So, what can employers do to help their employees stay healthy and control their costs?
By Barbara Rutkowski
Published December 08 2017, 12:10pm EST
IRVING, Texas, Oct. 24, 2017 -- Rick Scheel recently joined Advanced Plan for Health as Vice President of National Sales. Rick is leveraging his many years of successfully working with large organizations to share the power of the Poindexter platform. Poindexter provides powerful analytical tools to help large organizations such as health plans, TPA’s, brokers / consultants, managed care organizations and employers gain critical insight into their current healthcare spend as well as a view into their future healthcare spend.
IRVING, Texas, Oct. 17, 2017-- Yvonne Daugherty has joined Advanced Plan for Health as Vice President of Development, and is overseeing marketing and supporting client retention for this health data analytics solution provider. In her new role, she will be working with health plan, TPA, broker / consultant and integrated delivery network clients nationwide as they utilize the APH Poindexter platform to better control rising healthcare costs, close gaps in care, and improve health outcomes.
Predictive analytics in healthcare can benefit organizations two-fold. This technology not only helps better manage a population but also better handle claims and save money.
Speaking of wellness programs, if analytics can predict and help employers better design their health plans, couldn’t the technology also be used to help prevent or put off more adverse and expensive health events
The new platform enables self-insured employers to predict health events, hospital admissions, length of stay and other incidents.