News & Press

May 23, 2019

Utilize Health Releases Ground-Breaking White Paper On The Cost and Human Toll of Neurological Conditions

NASHVILLE, Tenn. May 21, 2019 — Targeted neurological care solution company Utilize Health has released an innovative white paper on The Cost and Human Toll of Neurological Conditions. The first in a planned series, this volume focuses on the challenges of individuals, health systems, and health plans in the management of traumatic brain injury (TBI). The series will also include a webinar and podcast.

According to a report in Neurology Today, neurological conditions drive a staggering $800 billion in annual U.S. healthcare costs. A subset of six neurological conditions including, TBI, stroke, spinal cord injury (SCI), multiple sclerosis, muscular dystrophy, and cerebral palsy drive a third of those costs, or $240 billion annually. TBI alone¾which impacts Americans ranging from infants to the elderly¾drives more than $86 billion in annual US healthcare costs.

Utilize Health’s new white paper draws from a growing body of literature on the rising incidence and prevalence of TBI in America and its dramatic impact on healthcare quality, medical cost and our society. In addition to an alarming increase in TBI, a 2018 study from the Journal of the American Medical Association and an eye-opening Report to Congress highlight the growing need for access to innovative technology and digital health approaches in neurological care to empower outreach, engagement, and address other quality care access barriers including social determinants of health.

“From the shocking Report to Congress to coverage in the media, evidence supports that the debilitating and potentially lifelong impact of TBI is not limited to any specific age band or health plan population,” said Utilize Health CEO Jessica Harthcock, herself a testament to optimized recovery in SCI.  “TBI isn’t just a problem for Medicare or Medicaid, our data shows that the cost of TBI is a significant expenditure for commercial health plans.”

A recent neuro-specific claims analysis conducted by Utilize Health for a mid-sized health plan identified more than $40 million in quality driven medical cost savings opportunities. The proprietary analysis included all commercial and government sponsored lines of business and focused on six key neurological conditions managed by Utilize Health, including TBI, stroke, SCI, multiple sclerosis, muscular dystrophy, and cerebral palsy.

“The problem begins post-discharge,” said Utilize Health Chief Clinical Officer Rebecca Baker. “The daily and often lifelong challenges faced by individuals with a TBI include physical, cognitive, social, and emotional disabilities. Their symptoms can range from chronic pain to extensive paralysis and even to personality changes such as depression and increased aggression,” stated Baker. “Published evidence and our own findings from data sets across the U.S. confirm these challenges are poorly addressed outside of the acute care setting.”

Although post-discharge follow up is critical to prevent exacerbation of Associated Neurological Sensitive Conditions (ANSC) and Ambulatory Care Sensitive Conditions (ACSC) as established by CMS and AHRQ guidelines, research shows that only 44 percent of patients reported seeing a physician within three months following a TBI. Another recurring theme throughout TBI literature is the lack of access to quality, specialized rehabilitative facilities, resulting in high utilization of inappropriate care settings.

“Through our neuro-specific algorithms, analysis and outreach, we’ve found that many of the challenges experienced in TBI are common to other key neurological conditions we manage,” shared Harthcock. “That’s why Utilize Health exists—to identify these challenges within managed populations and empower early, lasting positive change for the individuals we serve and the families and caregivers who support them.”

At Utilize Health, no one walks alone.

Headquartered in Nashville Tennessee, Utilize Health is a targeted neurological care solution. Its proprietary analytics identify and target neurological expenditures hidden within claims. Utilize Health’s programs combine evidence-based guidelines with interdisciplinary, collaborative care management for early symptom identification to prevent risk escalation. By facilitating access to appropriate, quality rehabilitation centers and empowering members to be active partners in their recovery, Utilize Health’s program improves health, enhances member and provider satisfaction, and significantly reduces medical cost by focusing on quality and optimized recovery.

For more information, visit www.utilizehealth.com


Shaw G. (2017). The Economic Burden of Neurologic Disease – $800 Billion Annually in the US. Neurology Today, 17, 14-18.
Seabury, S. A. et al. Assessment of Follow-up Care After Emergency Department Presentation for Mild Traumatic Brain Injury and Concussion. JAMA Network. Open 1, e180210 (2018).
Centers for Disease Control and Prevention. Report to Congress on Traumatic Brain Injury In the United States: Epidemiology and Rehabilitation. National Center for Injury Prevention and Control; Division of Unintentional Injury Prevention. Atlanta, GA (2015).

 

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