DENVER--(BUSINESS WIRE)--BridgeHealth, a leading provider of high-quality, lower-cost, bundled surgical case rate benefit plans, today announced that client plan sponsors have saved 20-40 percent on surgical healthcare costs by arranging surgeries for members through BridgeHealth instead of through their primary PPO health plans.
The findings are based on a comparison of clients’ claim costs, fees and expenses through traditional in-network managed care plans versus their costs through BridgeHealth for surgeries from 2013 to 2016.
Surgical costs represent the largest component of U.S. healthcare spending, at approximately $1 trillion, or 31 percent of annual healthcare spending. Surgical complications, which arise at an alarming rate, can drive up the cost of care by 93 percent. Additionally, nearly 30 percent of surgical procedures are medically unnecessary, further increasing the cost of healthcare for employers.
“Rather than allow rising healthcare costs to constrain them, employers are thinking out of the box, adopting highly innovative measures to rein in this spiraling spend,” said Mark Stadler, BridgeHealth’s chief executive officer. “One innovative approach is bundled pricing at centers of excellence for scheduled surgeries. Four years of data show this approach provides much needed relief to employers and employees alike.”
BridgeHealth is the leader in bundled surgical solutions through centers of excellence. BridgeHealth identifies top-quartile hospitals and surgical centers – by practice, procedure and specific physician group – and negotiates with these high-performing surgical teams for episode-of-care case rates, bundling the various charges for each surgery into a single price that is significantly less than that of typical PPO plans.
Provider ratings come from a nationally recognized, independent healthcare quality ranking service. Just 10-15 percent of hospitals and ambulatory surgery centers nationwide qualify for BridgeHealth’s programs. Patients travel to these centers of excellence for any of 150 orthopedic, spine, women’s health, bariatric, cardiac, neurological and general surgical procedures.
“With the high quality delivered by our surgery partners, very few patients experience postoperative complications,” said Kim Abram, BridgeHealth’s director of provider contracting. “The employee has the best possible surgery experience, and the employer avoids unexpected costs due to hospital readmissions, ER visits, disability, loss of productivity, absenteeism and diminished productivity on the job.”
BridgeHealth brings the negotiated case rates to its client organizations – typically large self-insured corporations. The clients develop incentives for eligible employees to use the voluntary program by waiving deductibles and coinsurance and paying for travel and accommodations. Even with the cost of incentives and travel, BridgeHealth clients enjoy positive ROI averaging 4:1.
BridgeHealth coordinates everything for the employer and the plan member. “Our care coordinators assist plan members with decision support, case review, surgery scheduling and travel arrangements, eliminating much of the stress associated with planned surgery,” Abram said.
About BridgeHealth
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.