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November 01, 2018

Report: Health Plans Spend $240 Billion Annually on these 6 Neuro Conditions. How Much is Preventable?

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Register for our November WHCC webinar: How a Health Plan Reduced Neuro-Related Medical Expenditures by 14% within 6 Months

It is now recognized that six neurological condition categories drive $240 Billion annually.1 These conditions include traumatic brain injury (TBI), stroke, spinal cord injury, multiple sclerosis, muscular dystrophy, and cerebral palsy.

  • A 2018 health plan claims analysis revealed annual medical expenditure growth in excess of 25 percent for these top six condition categories.2
  • Further, data supports these expenditures are driven largely by preventable complications.3

TBI Alone Drives >$86 Billion in Annual Cost. How Much is Preventable? Recent Report to Congress Sheds Light on Gaps and Opportunities

While there is a wealth of published data on the neurological costs of stroke (>$118 Billion annually in the U.S.); 1 historically, there has been little focus on TBI despite its rising cost, incidence and prevalence across population age bands and sites of care. A groundbreaking report to Congress on TBI has served as a catalyst for change. Since its publication, a growing number of studies and articles have emerged to confirm the challenges and opportunities presented by mounting awareness of TBI and its impact on care quality and cost, communities, health disparities, and on society as a whole.

Key Findings4 of the Report Include:

  • The current body of evidence does not support the presence of a true post-acute standard of care including “optimal dose or intensity of therapy, the ideal timing of therapy in the recovery process, or the necessary modifications for subpopulations.”
  • “A growing body of research on TBI and recovery has demonstrated benefits of high-intensity intervention, even during later stages of recovery.”
  • TBI recovery is influenced by individual patient characteristics, available support systems, access to appropriate rehabilitation, and other social-environmental factors.
  • “Use of tele-health and web-based technologies that provide access to expert consultation … can help to overcome barriers to rehabilitation access, such as geographic residence and lack of transportation.”

Innovation in Neuro Care Management Achieves 14 Percent Savings within 6 Months5

Utilize Health’s innovative neuro care management program helps health plans improve quality and cost of care through expert, multichannel engagement and care navigation solutions tailored to each member’s specific condition and needs. Our program addresses the top six drivers of neurological costs (TBI, stroke, spinal cord injury, multiple sclerosis, muscular dystrophy, and cerebral palsy) in addition to concomitant conditions identified by our proprietary algorithms as early indicators of rising risk and impending clinical complications.

Utilize Health’s deep neurological experience and member support, in concert with our proprietary FacilityOptimizerTM application, makes our solution wholly unique, delivering savings of 14 percent within the first 6 months of member participation. Our support extends beyond participating members to help coordinate needs across the care management team, from designated caregivers, to quality in-network providers, to the care/case managers and health plans who serve them.

Contact Utilize Health Today

We offer flexible funding models and are willing to guarantee results with fees at risk. Our program is easily launched and provides a strong ROI. Programs can go live in January for a full year of savings or begin at any time during the year to help improve quality and cost.

To learn more about optimized support for your members with neurological conditions, contact Utilize Health today at 732.539.6086 or email lon.hecht@myutilizehealth.com.

Register for our November WHCC webinar: How a Health Plan Reduced Neuro-Related Medical Expenditures by 14% within 6 Months

 

About Utilize Health

Headquartered in Nashville Tennessee, Utilize Health is a neurological specialty care management company. Our proprietary analysis identifies and targets neurological expenditures hidden within medical claims. Our programs combine evidence-based guidelines with interdisciplinary, collaborative care management for early symptom identification to prevent risk escalation. Leveraging intensively trained, specialized clinicians and a suite of digital tools, we ensure the best possible match of member, condition, therapy, and facility. Our specialized clinicians have a minimum of 8+ years of neurological care experience in at least two discrete care settings, and our neurological FacilityFinderTM is the only tool of its kind on the market. Utilize Health’s ongoing program engagement and support not only helps improve quality of care but also enhances member, caregiver, and provider satisfaction.

 

Citations:
1The Economic Burden of Neurologic Disease — $800 Billion Annually in the US; Shaw, Gina; Neurology Today, 17(12):1,14-18, June 22, 2017; doi: 10.1097/01.NT.0000521169.52982.7f.

2Utilize Health, data on file.

3Utilize Health, data on file.

4Centers for Disease Control and Prevention. (2015). 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.

5Utilize Health, data on file.