Flat fees and EMR usage vary significantly in different hospitals

Sep 4 2009

HighRoads, the company providing employers – for the first time – complete control over their health care costs and compliance, today announced findings from the industry’s first medical travel request for information (RFI) for Fortune 500 employers to compare health care procedural ethics, quality and costs around the world. Initial results show that flat pricing, surgeon compensation and use of electronic medical records vary dramatically from hospital to hospital.

HighRoads’ first Medical Travel survey represents 66 vanguard facilities including over 50 U.S. hospitals and ambulatory surgery facilities and 11 outside the U.S. These health care organizations, including BridgeHealth, Healthplace America, HIMA Health, Intermountain Healthcare and Scott & White, responded to HighRoads first medical travel request for information based on their desire to introduce procedural cost and quality transparency and reduce health care costs.

Leveraging HighRoads industry-standard benefits management technology, the RFI was designed to provide Fortune 500 employers comparable ethical, quality and flat fee data to make the best choice for superior medical procedures for employees at the lowest possible cost. The HighRoads Medical Travel RFI included questions such as:

• When patients come to your hospital/clinic for a surgical procedure, are such patients screened by impartial physicians, other than the physician who will perform the surgery?
• Which describes the surgeons who perform surgery through your hospital/clinic:
  • Salaried
  • Salaried with paid incentives based on volume or revenue generated
  • Paid on a fee for service basis
• If your hospital/clinic provides a flat price for eight major procedures including aortic valve replacement, total hip replacement, cholecystectomy, please provide your prices in US dollars, the average number of cases per month, mortality rates and infection rates.

Some of the initial survey findings include:

• Flat pricing varied up to $40,000 for the same. Example flat prices for coronary artery bypass surgery ranged from $19,000 to $59,279, and for total hip replacement from $9,900 to $29,005 U.S. dollars.
• 48% of responses indicated patient or plan sponsors would have to pay fees to third parties who have negotiated their flat fees
• 57% of respondents indicated they use electronic medical records

“I have been leveraging medical travel for the past 14 years to improve the quality of medical care, reduce the practice of unnecessary procedures in order to improve the health of US employees, while reducing health care costs,” said Tom Emerick, President of Emerick Consulting, and former VP of Benefits for Walmart Stores, Inc. ”HighRoads’ application of its technology to provide a transparent database of worldwide ethics, quality and flat prices for medical procedures will accelerate the adoption of medical travel and can dramatically reduce health care costs for patients, insurers and employers.”

“Employers need an efficient mechanism to compare the ethics, quality and cost of medical procedures at top healthcare centers,” said Michael Byers, CEO and president, HighRoads. “It is too complex and time consuming to attempt alone. This is why HighRoads has developed a technology platform that will automate this data collection and comparison so employers have increased choices when it comes to the safest and healthiest options for their employees.”