The following figure compares the U.S. average premium cost to two of HSR’s major clients. Costs were tracked over five years and show remarkable successes in flattening costs in the wake of the rapidly rising U.S. average.
- Health promotion – “Keeping low risk people healthy”
- Condition management – “Just don’t get worse.” *
- Medical and care management using UR and CM.
*Dee Edington, University of Michigan
Once at risk people are detected, they can be placed under supervision of a RN health coach to ensure their health does not deteriorate due to lack of knowledge, or lack of compliance with medical protocols designed to help them stabilize and improve their health.
Our staff are all senior RN’s and are not managed like big insurance company call centers, where volume of calls and immediate reduction of costs are the metrics. HSR’s RN’s are guided to treat patients like family members, spend as much time as necessary to help them, and are measured on the best quality healthcare. They are not incented to reduce immediate costs, because to focus on immediate cost sets up a time bomb for larger catastrophic costs and drastically reduced quality of life.
Our RN’s average 13 years with HSR. This means we can invest more heavily in training and development than our competitors who have average turnover rates, or lower ratios of nurses to employees served.
How HSR Clients Get 30:1 ROI
In today’s healthcare landscape it is just a matter of time before “an actuarial moment,” or catastrophic event occurs.
Dialysis: Historically, we have negotiated better dialysis pricing than our much larger competitors. Why? Because our nurses have the experience and insight in negotiations with providers to recognize who will provide exceptional quality and when to push for lower pricing.
Out of network deals. Big insurance’s main weakness is inflexibility. If a provider is not in their network they won’t negotiate. Therefore the employee and the health plan both take a big hit. Our nurses call ahead, regardless of network, and arrange the discount. We saved one client $160,000 on an out of network procedure in California.
Patients are like family: Consistently moving people to step down units, skilled nursing facilities (SNF), or even their homes, as soon as medically appropriate. This ties into our quality focus and the philosophy of treating patients as we would our own family members.
Educated consumers: HSR educates the patient and their families to take an active role in their healthcare. When patients become educated consumers their cost becomes lower and they also benefit from lower out of pocket costs.
Rule out medicine: Going to the wrong specialist who does all they can, at great cost, and in the end says “I can’t help you.” This is great flaw in the American healthcare system. HSR’s nurses find the right specialist for you.
Measure Right Things to Get Right Results:
The following figure shows the HSR’s key metrics for all clients compared to the U.S. average. These result from treating patients like family and getting them the best quality healthcare.
Strong systems, strong people, great results.
That’s HSR, the leader in healthcare cost management
Contact
Health Service Review,
6730 Roosevelt Avenue, Franklin Ohio 45005
Phone 513-422-2265
Fax 513-422-2265
www.healthservicereview.com
