How providers & brokers can bend cost curve, improve outcomes

The more employees know about their care and treatment options, the greater the potential for savings.

We all know health care costs continue to increase year over year, often by more than 5 percent. But what if I told you that right now, approximately 6 percent of your clients’ medical spend was on just five common surgeries? What if I went on to tell you that as often as half of the time, these surgeries may not be needed, according to medical evidence, and/or are not wanted by employees, who have other treatment options. This would represent an incredible opportunity to bend the cost trend and improve health outcomes.

The big brains behind the Dartmouth Atlas were among the first to clue us in that there is widespread variation in the number and types of surgeries performed across the country. For example, one major metropolitan city may have patients three times more likely to have a knee replacement, compared to another. The explanation for the difference is not the patient population — it is the surgeons. In some regions, it is more fashionable or culturally acceptable to reach for the scalpel as the first option, even when medical evidence says there are other treatment options. And, of course, in many of these cases, the patient would want a less invasive treatment option, too.