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Surgery Optimization Service that Guides Plan Members to both High Quality Surgeons and Ambulatory Facilities Resulting in Lower All-in Surgery Costs HR.

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Presentation on theme: "Surgery Optimization Service that Guides Plan Members to both High Quality Surgeons and Ambulatory Facilities Resulting in Lower All-in Surgery Costs HR."— Presentation transcript:

1 Surgery Optimization Service that Guides Plan Members to both High Quality Surgeons and Ambulatory Facilities Resulting in Lower All-in Surgery Costs HR Specialty Products & Services Catalogue Executive Summary A No Frills Distillation of Vendor’s Marketing Collateral Thomas A Ference President & CEO Human Resources Mining & Distribution Co Locating, Validating and Accelerating HR  Innovation Office: Cell: Fax: Website:

2 Surgery Optimization Service
PPO plans limit physician and facility access and deliver multiple, poorly-linked provider bills. These bills arrive months later which can mask the cost of the total surgery itself, post-op infections and subsequent readmissions. This vendor instead, screens surgeons and Ambulatory Surgery Centers (ASC’s) via a proprietary vetting processes. It then concierge’s plan members to providers in their local area. Because of their patient -first design and rigorous patient care processes, ASC’s and attendant physicians conduct surgeries more efficiently and with less post-op infections

3 Surgery Optimization Service
CDC reports that 4% of patients contract a “Hospital Associated Infection” whereas they are less than 1% in this ASC network. Such HAI’s / infections have no PPO schedule and plan sponsors never receive reports itemizing infection costs. Service also includes bundling of all provider bills into a single bill and EOB to allow for the tracking of both all-in surgery costs and patient outcomes. Concierge explains doctors orders to insure they are understood and followed, and continue to work with the patient through the entire episode of care (90 days). Costs are on average 50% less than hospitals and employer cost reductions have been $1.5 million per 1000 employees.

4 High Hospital Infection Rates
Bloodstream Infections - $30,919 - $65,245 Ventilator – Associated Pneumonia - $36,286 - $44,220 Surgical Site Infection - $18,902 - $22,667 Clostridium Difficile Infection - $9,118 - $13,574 Catheter Associated Infections - $603 - $1,189 Total cost of these top 5 infections is estimated to be between $8.3 - $11.5 Billion per year.

5 Ambulatory Surgery Centers
More Efficient – All surgeries are planned, no emergency care, and streamlined clinical workflow More Affordable – Focus on a few specialties coupled with lower facility and operating costs means they can controls cost more efficiently than Hospitals ASCs were built with a patient first culture in mind and give personal care to every patient More time one-on-one time with the physician and a higher RN to patient ratio, means a better outcome and a more informed patient Wait times at ASCs are lower vs. Hospitals and surgeon availability is higher as physicians focus on fewer patients and fewer procedures

6 150+ Specific Surgeries Included In Categories Below
Diagnosis Code General Classification A Infectious and Parasitic Diseases C Neoplasms G Nervous System Eye and Adnexa, Ear and Mastoid Process   I Circulatory System J Respiratory System K Digestive System L Skin and Subcutaneous Tissue M Musculoskeletal and Connective Tissue N Genitourinary System S & T Injury, Poisoning, Certain Other Consequences of External Causes V External Causes of Morbidity

7 Next Steps This product/service is contained in the HR Specialty Products & Services Catalogue™ Operational level details about this particular service provider can be obtained in conference with the vendor The HR Mining &Distribution Co. is an independent and contracted representative of the vendor Upon your request, we will arrange for an introduction that can range from a simple, quick conference call to a services overview / system demo Tom Ference (Chicagoland area) or Thank you for your potential interest in this fresh thinking


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