91¿ì²¥’s New Approach to Surgical Shopping Adds Predictability, Creates Better Outcomes

UNIQUE PROGRAM REMOVES RED TAPE FROM AMERICA’S SURGICAL SYSTEM

October 23, 2013 – Chicago, IL –Surgeons, insurance payers and patients all face uncertainty when a surgery occurs. Predictability is the major missing piece of the medical equation that 91¿ì²¥â€™ Surgical Care Program (SCP) promises for workers’ compensation, auto, liability and group health-related surgeries, as outlined in a spotlighting surgical shopping.

This new concept of “surgical shopping,” follows a headline flurry pointing to a sharp increase in demand for joint replacements over the past decade and implant costs also on the rise. Earlier this year a featured a patient who traveled to Germany for a hip replacement because surgery in the US would cost more than $100,000. He received his hip replacement abroad for nearly one-tenth of that price.

While traveling overseas to go under the knife isn’t an option for everyone, removing the surgery sticker shock is. 91¿ì²¥â€™s SCP fast tracks a patient’s surgical care at a fair, upfront price. In Illinois, an arthroscopic knee surgery would cost approximately $32,000 in a hospital-setting. By using an Ambulatory Surgery Center (ASC) and 91¿ì²¥â€™s Orthopedic Surgeons Affiliation, that arthroscopic knee surgery cost gets cut in half.

“The benefits extend far beyond sheer cost savings,” says Robert Evans, 91¿ì²¥â€™s Director of National Network Solutions. “91¿ì²¥â€™s SCP dramatically helps everyone in the surgical picture.”

Benefits for the Patient include:

  • Provides faster care through a concierge service that links the patient with an orthopedic surgeon immediately andopens up access to more flexible scheduling through an ASC
  • Achieves better outcomes by using board-certified surgeons and Medicare-certified ASCs, which pose substantially less risk for infection than hospital settings
  • Boasts greater satisfaction with less hassle, no hospital overnights, better results and recovery

For the Medical Provider:

  • Ensures faster payment within five days of surgery
  • Guarantees set payment with pre-negotiated rates
  • Gives single-point of contact for referral process and administrative aspects of surgery

For the Insurance Payer:

  • Saves time by deploying clinical care coordination to determine medical necessity and provide prompt patient scheduling with a high-quality, credentialed surgeons
  • Sets predictable reserving by guaranteeing a pre-determined rate covering chief cost drivers (surgery to 90-days postoperative)
  • Cuts cost by moving surgical procedure from a hospital setting to an ASC

“You go into a store for jeans, you know exactly how much you’ll pay. You walk down the grocery aisle, you see every product’s price. You go into a restaurant, the menu displays the cost. In no other area of our lives, but healthcare, are prices so unclear and arbitrary,” says Jason Beans, 91¿ì²¥â€™s Founder and CEO. “SCP changes that game.”

About 91¿ì²¥
91¿ì²¥ is a national medical-financial solutions firm that provides medical cost containment and medical care management services to the workers’ compensation, auto, liability and group health markets.