First Las Vegas Concierge Medical Boutique Caters To Kids

By | Healthcare Tourism OPM

Dr. George recognizes Las Vegas’ littlest VIP’s demand Concierge Medicine, too.

Constantine George is not your typical Board Certified Internist & Pediatrician, and his clients are thankful. After having dedicated much of 2016 to his growing practice and as Medical Director of RESORTCIERGE MD (an exclusively dedicated house call medical concierge provider) he has quickly recognized that many of the requests are for the city’s littlest VIP’s- our children. And, if there’s one thing that a compassionate and skilled Pediatrician knows how to do best, it is to be proactive! Thus, announcing HYGEIA HEALTH AND WELLNESS, which is the first Concierge Medical Group that caters to Adults & Children in Las Vegas, was a clear next step.

“Imagine the peace of mind of having access 24/7 to a physician for your entire family” says Dr. Constantine George. “I wanted to create the ideal medical environment, one where I wanted to bring myself and my own family.”  For a yearly fee, families have access to a highly personal service that’s well-equipped to track any and all aspects of their family’s health, 24 hours a day

HYGIEA Members can come in as often as they want and are encouraged to call with questions to help manage their care. Given the rising costs of medical care, this level of service is not seen as overly extravagant especially in a city that boasts the best of the best, so why should medical concierge for pediatrics be any different?

HYGIEA is the first combined Internal Medicine/Pediatrics concierge private practice in Las Vegas.  A medical experience that blends the hospitality of Las Vegas with your clinical evaluation.  Whether you arrive by private car with assigned covered parking accessibility or are dropped off by limousine, you will be treated to an experience like no other in our serene environment.  From check in to check out, you are guided along each step of your medical work up. Convenient access to your physician is available in the form of same day appointments or after-hours phone calls / texting or emails. Follow up phone calls and emails ensure that our patients’ needs are exceeded.  In addition to primary care services, HYGEIA HEALTH AND WELLNESS provides a multitude of services including but not limited to:

Executive Physical Exams:  Building upon their exclusive relationship with New York based EHE International-the gold standard in executive health exams, Dr. Constantine George and his team offer unparalleled services for your executive healthcare experience.  Gone is the need to fly to the Mayo Clinic or Scripps Clinic. You can now have your executives stay local and get their executive physicals done in the comfort of their own backyard. With impeccable follow up and continuity of care in Las Vegas, there is no longer a need to seek services outside of our valley.

Personalized Care: Longer appointments and immediate access to physicians is our practice. We reduce the volume of patients to just a fraction of the size so that your appointment is customized to your specific needs. We will also help coordinate care for our patients any time you need a specialist or the hospital, ensuring continuity of care and assisting to eliminate the needless (and costly) burden of extra visits and evaluations.

Convenience and Peace of Mind:  Afterhours access to Dr. George is customary in addition to same-day or next-day appointments with minimal or no wait times in a serene, comforting atmosphere. We also have reserved covered parking or can assist in securing a private limo, SUV or sedan services. We are conveniently located on West Flamingo near Durango with easy access from the I-215 or 1-15.

Affordable Luxury: Our yearly individual membership is unexpectedly affordable and we also accept most insurance plans for visits or a family membership for you and your family is also available.  Concierge medicine can lower healthcare costs by spending more time with each patient, Dr. George can help manage conditions that often require complex care and management including coordinating between different care providers and specialties.

House Call Physicians:  Dr. Constantine George serves as medical director of RESORCIERGE MD.  World class medical care coupled with on demand House Call medicine is what RESORTCIERGE MD delivers, 24/7/365.

About HYGEIA HEALTH AND WELLNESS

HYGEIA HEALTH AND WELLNESS, founded by native Dr. Constantine George whom is board certified in Internal Medicine and Pediatrics, is dedicated to providing premier customer service and exceptional personalized medical care for all ages. HYGEIA is the ONLY local Center of its kind, exclusively dedicated to both adults and children. HYGEIA is open Monday – Friday 8:30 a.m. –4:30 p.m. and conveniently located in Las Vegas at 8859 W. Flamingo Road, Las Vegas, NV 89147.  For more information, please call 702- 419-3482.  Follow us on Twitter @HYGEIA_LV on Facebook at
https://www.facebook.com/HygeiaHealthandWellness/
and on the web at www.hygeiahealthandwellness.com. To JOIN our membership list (space is limited) please email us at hygeiahealthandwellness@gmail.com

About RESORTCIERGE MD

RESORTCIERGE MD (RCMD) is the top House Call Concierge Medical provider dedicated to servicing Las Vegas luxury resorts 24/7/365. Founded by world-class Concierge professional, Tyra Bell-Holland, who served as a member of Les Clefs d’Or and President pro tem of The Southern Nevada Hotel Concierge Association, it is the perfect coupling of luxury service and exceptional medicine committed to Medical Tourism in Southern Nevada. 1-844-MY-CIERGE-MD (1-844-692-4374) or visit www.resortciergemd.com

HYGEIA HEALTH AND WELLNESS Grand Opening Media/VIP Event

By | Events, Healthcare Events, Healthcare Tourism OPM | No Comments

Local Las Vegas Leading Doctor Crafts Concierge Medical Boutique Dedicated to Hospitality Healthcare Dr. Constantine George announces Grand Opening Media/VIP Event Tuesday, June 14, 2016 Las Vegas, NV.

In Las Vegas, hospitality is at the forefront of every major business and is the leading competitive factor to success.  Every major hotel/casino extensively trains staff, no matter their position, on the attitude and language required to acknowledge guests and create a welcoming atmosphere to set their brand apart from the rest.  Why not extend this idea of customer service and hospitality to healthcare?  Patients want to feel welcomed and appreciated, especially while seeking medical care.  Understanding that patients are truly guests of the healthcare system is the first critical step of incorporating hospitality into healthcare and helping Las Vegas grow as an international medical tourism destination. HYGEIA HEALTH AND WELLNESS and RESORTCIERGE MD are leading the way.

To formally introduce HYGEIA HEALTH AND WELLNESS to the community, we are hosting a Media & VIP event on:

Tuesday, June 14, 2016
5:30PM-7:30PM
KINDLY RSVP by:  6/10/16
pr@avaroseagency.com
8859 W. Flamingo Road, Las Vegas, NV 89147  

Come meet Dr. Constantine George & the HYGIEA team while mingling with community leaders from medicine, hospitality, gaming, tourism and more! We will be serving bubbles, small bites and have great raffle prizes including memberships to HYGEIA HEALTH AND WELLNESS Concierge Medical Group.

HYGIEA is the first combined Internal Medicine/Pediatrics concierge private practice in Las Vegas.  A medical experience that blends the hospitality of Las Vegas with your clinical evaluation.  Whether you arrive by private car with assigned covered parking accessibility or are dropped off by limousine, you will be treated to an experience like no other in our serene environment.  From check in to check out, you are guided along each step of your medical work up. Convenient access to your physician is available in the form of same day appointments or after-hours phone calls / texting or emails. Follow up phone calls and emails ensure that our patients’ needs are exceeded.  In addition to primary care services, Hygeia Health and Wellness provides a multitude of services including but not limited to:

Executive Physical Exams:  Building upon their exclusive relationship with New York based EHE International-the gold standard in executive health exams, Dr. Constantine George and his team offer unparalleled services for your executive healthcare experience.  Gone is the need to fly to the Mayo Clinic or Scripps Clinic. You can now have your executives stay local and get their executive physicals done in the comfort of their own backyard. With impeccable follow up and continuity of care in Las Vegas, there is no longer a need to seek services outside of our valley.
Personalized Care: Longer appointments and immediate access to physicians is our practice. We reduce the volume of patients to just a fraction of the size so that your appointment is customized to your specific needs. We will also help coordinate care for our patients any time you need a specialist or the hospital, ensuring continuity of care and assisting to eliminate the needless (and costly) burden of extra visits and evaluations.

Convenience and Peace of Mind:  After-hours access to Dr. George is customary in addition to same-day or next-day appointments with minimal or no wait times in a serene, comforting atmosphere. We also have reserved covered parking or can assist in securing a private limo, SUV or sedan services. We are conveniently located on West Flamingo near Durango with easy access from the I-215 or 1-15.

Affordable Luxury: Our yearly individual membership is unexpectedly affordable and we also accept most insurance plans for visits or a family membership for you and your family is also available.  Concierge medicine can lower healthcare costs by spending more time with each patient. Dr. George can help manage conditions that often require complex care and management including coordinating between different care providers and specialties.

House Call Physicians:  Dr. Constantine George serves as medical director of RESORCIERGE MD.  World class medical care coupled with on demand House Call medicine is what RESORTCIERGE MD delivers, 24/7/365.
With an ever-changing healthcare landscape, many patients today are looking for ways that they can better manage disease and get the care they need from a physician who truly cares about helping them be healthier. The increased cost of belonging to a boutique or concierge practice is often worth the increased benefit for many patients, particularly those who value their time and those who have increasingly complex medical conditions to manage.
For most people, spending a little bit of extra money to be part of a private practice is an investment in your long-term health and wellness. The results and benefits of having a physician who truly knows you and provides you with the highest level of service and care are worth the investment. This is the commitment made to you by HYGEIA.
About HYGEIA HEALTH AND WELLNESS
HYGEIA HEALTH AND WELLNESS, founded by native Dr. Constantine George whom is board certified in Internal Medicine and Pediatrics, is dedicated to providing premier customer service and exceptional personalized medical care for all ages. HYGEIA is the ONLY local Center of its kind, exclusively dedicated to both adults and children. HYGEIA is open Monday – Friday 8:30 a.m. –4:30 p.m. and conveniently located in Las Vegas at 8859 W. Flamingo Road, Las Vegas, NV 89147.  For more information, please call 702419-3482.  Follow us on Twitter @HYGEIA_LV on Facebook at https://www.facebook.com/HygeiaHealthandWellness/ and on the web at www.hygeiahealthandwellness.com. To JOIN our membership list (space is limited) please email us at hygeiahealthandwellness@gmail.com
About RESORTCIERGE MD
RESORTCIERGE MD (RCMD) is the top House Call Concierge Medical provider dedicated to servicing Las Vegas luxury resorts 24/7/365. Founded by world-class Concierge professional, Tyra Bell-Holland, who served as a member of Les Clefs d’Or and President pro tem of The Southern Nevada Hotel Concierge Association, it is the perfect coupling of luxury service and exceptional medicine committed to Medical Tourism in Southern Nevada. 1-844-MY-CIERGE-MD (1-844-692-4374) or visit www.resortciergemd.com.

Las Vegas Woman First In Country to Receive ‘Revolutionary’ Bladder Cancer Treatment

By | Healthcare Innovation OPM, Healthcare Tourism OPM | No Comments

A groundbreaking bladder cancer treatment was approved by the FDA this week, generating new hope for the 76,000 Americans diagnosed with the disease every year. The first patient to receive the commercial treatment lives in Las Vegas. (……and is being treated by Comprehensive Cancer Centers of Nevada’s Dr. Nick Vogelzang)

“It’s going to make chemotherapy look like a dinosaur,” said Dr. Nicholas Vogelzang of the Comprehensive Cancer Centers of Nevada.

Image

Read more at: News 3 Las Vegas

Hospitals Should Do More Than Following The Hospitality Sector’s Lead In Its Client-Centric Approach

By | Healthcare Tourism OPM | No Comments

Lush trees and rolling fields occupied by orange-beak hornbills, swinging monkeys and hopping bunnies surrounded me. At the push of a button, I could call for room service to make up the bed, and warm meals prepared according to my requests would be sent to my room. In-room amenities included a flatscreen TV, a lounge sofa, a working table and in-suite bathroom facilities. Amiable butlers would swing around regularly for checks while the manager would drop in for a chat twice a day. In the compound, there were F&B outlets and cafes, a hair salon, gift shops and a 24/7 convenience store.

Read more at TTG ASIA

Some Firms Save Money By Offering Employees Free Surgery

By | Healthcare Tourism OPM, In The Media, Provider Reimbursements | No Comments

Lowe’s home improvement company, like a growing number of large companies nationwide, offers its employees an eye-catching benefit: Certain major surgeries at prestigious hospitals are free.

How do these firms do it? With a way of paying that’s gaining steam across the health care industry, and that Medicare is now adopting for hip and knee replacements in 67 metropolitan areas, including New York, Miami and Denver.

Here’s how the program works: visit npr.org for the full article.

To read more, visit npr.org.

Employers Of Every Size Embrace Medical Travel

By | Healthcare Tourism OPM, In The Media | No Comments

When faced with substantial monetary penalties for noncompliance, and the need to curb staggering health care costs, U.S. domestic medical travel represents an effective way for employers to lower costs while giving plan members access to quality care.   Medical travel – leaving one’s home state or region to travel to a designated health care “center of excellence” for high-quality, more-affordable surgical procedures or episodes of treatment – has been an important new strategy.

Read more in The Institute For HealthCare Consumerism.

Promoting Las Vegas As A Medical And Wellness Destination

By | Healthcare Tourism OPM, In The Media

While gambling, dining and shopping are popular reasons for visiting Las Vegas, several organizations have partnered to bolster the city’s reputation as a destination for medical and wellness tourism.

In 2014, the Las Vegas Convention and Visitors Authority (LVCVA), the Las Vegas Global Economic Alliance, Las Vegas Health Education Advocacy and Leadership of Southern Nevada, and the University of Nevada Las Vegas (UNLV) developed a strategic plan for medical and wellness tourism.

Read more in the International Medical Travel Journal.

Employer Direct Contracting: Significant Benefits For Employers, Providers And Patients

By | Healthcare Tourism OPM, Recent Releases

By Laura Carabello, Founder and Principal, CPR Strategic Marketing Communications, Editor and Publisher of Medical Travel Today and U.S. Domestic Medical TravelTM

Healthcare reform is kicking into high gear, impacting Employers, Providers and Patients across the United States. In particular, large Employers face substantial monetary penalties for non-compliance with the new regulations, even as the cost of providing health benefits continues to rise. In response, business leaders are adopting new strategies to combat the impact on the bottom line and ensure quality outcomes.

One strategy currently garnering significant attention is direct contracting with targeted Centers of Excellence (COEs) as pioneered by such companies as Wal-Mart, Lowe’s and Boeing. While the vast majority of large Employers – especially self-insured companies — are now contemplating these arrangements, virtually all mid-size and small Employers are equally receptive, especially when they are able to aggregate their purchasing power through coalitions and other multiple Employer welfare arrangements (MEWAs).

Direct contracting cuts administrative costs, helping Employers remain financially sustainable. It also gives Patients greater choice and a higher level of care. What’s more, this strategy helps hospitals and Providers, including ambulatory surgi-centers, attract more patients from outside their traditional catchment areas.

This is important given that the nation’s hospitals are under growing pressure to rein in staggering costs while improving quality of care.

How Does Direct Contracting Work?

Direct contracting, often characterized as “U.S. domestic travel,” is the practice of traveling out of one’s hometown or home state to a care provider or COE located in another part of the country.

Select hospitals must meet strict benchmarks for positive outcomes, low hospital-acquired infection rates, high Patient satisfaction, advanced staff training and skills, thorough patient data capture and other factors. Doctor’s costs, hospital expenses and fees are part of a single, transparent price.

Several organizations and purchasing coalitions are helping to guide Employers in their selection process. For example, The Pacific Business Group on Health (PBGH) brings Employers together with the aim of improving the quality of healthcare while moderating healthcare costs. PBGH’s 60 member companies provide healthcare coverage to 10 million Americans and their dependents, providing Employers with a wide array of services that range from advising on relationships with carriers, supporting projects that accelerate price and quality transparency, and advocating for policy initiatives.

One of the organization’s key members, Wal-Mart, launched a COE travel surgery program for cardiac and spine, and suggested that this type of program could have a stronger impact moving the market if multiple Employers joined together. Since then, PBGH has learned that Employers want a travel surgery program that offers high quality surgical care at affordable rates, not just an arrangement that provides the “best deal.”

Key Advantages to COE Programs

Among the many advantages to COE programs two stand out: price transparency and bundled pricing.

Price Transparency
Enormous variation in healthcare prices exists across the country. For example, one hospital might bill $40,000 to remove a gallbladder using minimally invasive surgery, while another hospital might charge $91,000.1

Prices can also vary within each state. For example, the median cost for a common inpatient heart procedure in southeastern Wisconsin ranges from a high of $178,647 at Waukesha Memorial Hospital to a low of $105,119 at Wheaton Franciscan All Saints in Racine.2

By only signing contracts with Providers priced in the low range, but who also demonstrate good outcomes, Employers can lower the cost of providing healthcare without compromising quality.

Bundled Pricing
Bundled payment, also known as episode-based payment or packaged pricing, is defined as the reimbursement of healthcare Providers based on expected costs for clinically defined episodes of care. Providers are paid a single fee for a set of evidenced-based services related to a diagnosis, with payments typically linked to outcomes, as well as other quality measures.3

Last year, the Department of Health and Human Services announced a “bundled” payment program that allows Providers to bid as a team for fixed price reimbursement for procedures, such as heart surgery or hip and knee replacements.4

This strategy incentivizes Providers to collaborate to ensure the best outcomes because any additional cost incurred beyond the fixed price comes out of the Provider’s pockets. As a result, Geisinger Health System, for example, has seen a 21% reduction in complications, a 25% reduction in surgical infections and a 44% drop in readmissions.5

Optimizing the Opportunity

While quality of care has traditionally been the primary deciding factor in choosing a hospital or Physician for a specific treatment or procedure, the cost of healthcare has become an increasingly important factor for consideration. As Patients have been asked to pay a greater proportion of the cost of their care – through higher co-pays, deductibles and other plan cost-sharing features – they are becoming more comfortable with the notion of leaving home to access better care that is easier on the pocketbook. Employers are also incentivizing Patients to make the journey: offering full coverage for the procedure, eliminating deductibles and out of pocket costs, and covering the travel costs of a companion or family member.

At the same time, hospitals and Providers are continually updating their offerings to lure corporate customers. In their quest to become recognized COEs, they seek to attract Patients from all parts of the country, and in many cases from throughout the world. For the most part, however, these care Providers are unsure about how to approach corporate audiences, market their capabilities, and leverage the opportunities that now exist throughout the country.

Implementation of a medical travel program is a complex undertaking, and the majority of health systems need guidance. Achieving clinical excellence is just one piece of the puzzle, and while most institutions like to point to their accomplishments in this area, they are missing many of the components for truly delivering an excellent, start-to-finish Patient experience.

Case in Point: Virginia Mason Medical Center

As more companies shift employees to high-deductible health Plans leading to higher out-of-pocket costs, more Employers are prompted to engage with local health systems as a way to help employees shop for cost-effective care.

Serving as a model for this trend, companies like Starbucks and Costco have aggressively forged relationships with medical centers to meet the kinds of rigorous standards they use in daily business practices. The results include better health, higher patient satisfaction and lower costs.6

To improve care for back pain, for example, Starbucks worked with Virginia Mason Medical Center, requiring same-day access for employees, no unnecessary medical care and 100 percent customer satisfaction. This supply-chain approach demanded the same high standards Starbucks expects from all of its suppliers. With fewer unnecessary tests and more use of therapists — which cost significantly less than use of doctors — Starbucks experienced lower costs in the treatment of back pain.7

What’s more, the standardized, efficient system also meant better outcomes. In fact, data showed that Virginia Mason’s spine clinic Patients returned to work more quickly, missing two days on average compared with five elsewhere.8

Strategies for COE Success

Market forces have created an opportunity for hospitals to offer Patient-centric care that focuses on better outcomes for every individual. Innovative services, however, must meet patient needs and expectations, and then provide guidance to Employers and care Providers to execute on their commitments to each and every person. What is needed is a single intersection for the healthcare medical travel industry, parallel to the “matching” programs for other industries such as dating, leisure travel, and business networking to accomplish these goals:

  • Empower Employers of all sizes with information and resources to pursue a medical travel program that generates the highest quality care at the greatest value.
  • Position hospitals and care Providers to serve Employers and their workforces.
  • Offer Web and event platforms to connect the audiences.

Today, the marketplace has literally forced health systems to compare themselves to institutions in a five-state radius or on another coast. What’s more, the need to travel is no longer a major concern for those seeking the best care at the best price.

As Plan members take on a greater share of their own healthcare costs, they are beginning to distinguish between low prices and high quality.9 At the same time, Employers are playing a more aggressive role by contracting directly with healthcare Providers and COEs in order to find the best value for their employees, and opting for bundled, fixed price procedures. This has created a new paradigm that generates benefits for every stakeholder across the healthcare continuum.

About the Author

Laura Carabello has been an entrepreneur and a strategy consultant in both domestic and international businesses related to healthcare and technology since 1985. She is the publisher/managing editor of Medical Travel Today, the authoritative, online business-to-business international newsletter of the medical tourism industry, as well as US Domestic Medical Travel, the newsletter dedicated to U.S. intra-state and inbound medical travel. In 2011, Carabello published Medical Travel Today: Opinions and Perspectives on an Industry in the Making. Ms. Carabello can be reached at

(201) 641-1911 x12, or by email at lcarabello@cpronline.com.

Read more in The Healthcare Savings Quarterly – December 2015.

U.S. Domestic Medical Travel: What Health Benefit Advisors Need To Know

By | Healthcare Tourism OPM, Recent Releases

In today’s complex health care environment, health benefit advisors have struggled to stay ahead of the curve in terms of helping employers rein in costs. Now, medical travel – leaving one’s home state or region to travel to a Center for Excellence (COE) for high quality, more affordable surgical procedures or episodes of treatment – has emerged as a key benefit option for a number of good reasons.

While there are no authoritative statistics regarding employer adoption of domestic medical travel programs, it is estimated that 15 percent of the nation’s 50 largest employers now offer this benefit option.

Significantly, top U.S. companies, including Wal-Mart, Lowe’s, Boeing and others, have begun offering U.S. domestic medical travel programs to their employees, covering the medical treatment and expenses, as well as expenses for a required caregiver.

Of particular interest is that many employers see the benefits of quality care and cost savings of a domestic surgery travel program and soon migrate to international medical travel where the savings are even more significant. In fact, about one million Americans sought medical treatment abroad in 2014, compared to about 750,000 in 2013, according to AARP Magazine. Experts expect this trend to increase 25 to 35 percent per year, with particular emphasis on procedures not traditionally covered by employer insurance such as dental or cosmetic work.i

How Does Domestic Medical Travel Work?

U.S. domestic travel is the practice of traveling out of one’s hometown or home state to a care provider or COE located in another part of the country. Domestic medical travel has also sparked a new breed of health management company that gives employers access to the country’s top hospitals and doctors – with transparent, predictable pricing.

The select hospitals involved in these programs must adhere to strict benchmarks for:
positive outcomes
low hospital-acquired infection rates
high patient satisfaction
advanced staff training and skills
thorough patient data capture and other factors
Doctor’s costs, hospital expenses and fees are part of a single, transparent price.

While large employers have dominated the domestic medical travel marketplace, many mid-sized and small employers are growing more receptive to this concept, and aggregating their purchasing power through coalitions and other multiple employer welfare arrangements (MEWAs).

Employers of all sizes build in incentive programs to prompt workforce uptake of the benefit, including waiving co-pays and deductibles, and covering both patient and companion/caregiver travel expenses. One of the drivers is the documented track record of a COE to achieve better results for specific procedures, mitigating complications, redos and readmissions – which can be very expensive in terms of hard costs, time lost from work and the health of employees.

Several organizations and purchasing coalitions are helping to guide employers in their selection process. For example, The Pacific Business Group on Health (PBGH) brings employers together with the aim of improving the quality of health care while moderating health care costs. PBGH’s 60 member companies provide health care coverage to 10 million Americans and their dependents,ii providing employers with a wide array of services that range from advising on relationships with carriers, supporting projects that accelerate price and quality transparency and advocating for policy initiatives.

One of the organization’s key members, Wal-Mart, launched a COE travel surgery program for cardiac and spine and suggested that this type of program could have a stronger impact moving the market if multiple employers joined together. Since then, PBGH has learned that employers want a travel surgery program that offers high quality surgical care at affordable rates, not just an arrangement that provides the “best deal.”

Key Factors in Choosing Medical Travel Options

With patients being asked to pay a greater proportion of the cost of their care – through higher co-pays, deductibles and other plan cost-sharing features – they are becoming more comfortable with the idea of medical travel to access better care that costs less out-of-pocket than what is available locally.

Having access to geographically-specific health care cost information will also be key to empowering patients to make more informed decisions regarding whether to travel for care and how to plan for it financially. Additionally, all stakeholders will benefit from price transparency and bundled pricing.

Price Transparency

Enormous variation in health care prices exists across the country. For example, one hospital might bill $40,000 to remove a gallbladder using minimally invasive surgery, while another hospital might charge $91,000, according to the New York Times.iii

Prices can also vary within each state. For example, the median cost for a common inpatient heart procedure in southeastern Wisconsin ranges from a high of $178,647 at Waukesha Memorial Hospital to a low of $105,119 at Wheaton Franciscan All Saints in Racine, according to Business Journal.iv By only signing contracts with providers priced in the low range, but who also demonstrate good outcomes, employers can lower the cost of providing health care without compromising quality.

Bundled Pricing

Bundled payment, also known as episode-based payment or packaged pricing, is defined as the reimbursement of health care providers based on expected costs for clinically defined episodes of care. Providers are paid a single fee for a set of evidenced-based services related to a diagnosis, with payments typically linked to outcomes, as well as other quality measures.

Last year, the Department of Health and Human Services announced a “bundled” payment program that allows providers to bid as a team for fixed price reimbursement for procedures, such as heart surgery or hip and knee replacements. This strategy incents providers to collaborate to ensure the best outcomes because any additional cost incurred beyond the fixed price comes out of the provider’s pockets.

Today, employers are playing a more aggressive role by contracting directly with health care providers and COEs in order to find the best value for their employees and opting for bundled, fixed-price procedures. This has created a new dynamic that is good news for benefits advisors, the companies they represent, plan members and the U.S. health care system as a whole.

About the Author

Laura Carabello has been an entrepreneur and a strategy consultant in both domestic and international businesses related to health care and technology since 1985. She is the publisher/managing editor of Medical Travel Today, the authoritative, online business-to-business international newsletter of the medical tourism industry, as well as US Domestic Medical Travel, the newsletter dedicated to U.S. intra-state and inbound medical travel. In 2011, Carabello published Medical Travel Today: Opinions and Perspectives on an Industry in the Making.

Read more at The Institute for HealthCare Consumerism.