We have developed health care management initiatives, systems and
interventions that are designed to support network caregivers and reduce
barriers to rapid change in clinical and administrative processes. You and
your employees benefit from enhanced accessibility, improved quality of
care and reduced costs.
Nearly 85% of the population is considered healthy, so they consume
only about 20% of the health care dollar. The focus on this group is to
maintain health and wellness through preventive health activities and
screening. Examples of our results include:
Typical organizations have many females between the ages of 42 and
69. Women in this age group should have a mammogram every 1-2
years. In preferred provider organizations 49% of women typically meet
this preventive expectation.
Aurora has worked with many populations to increase this
percentage to 70% or higher.
Of women over the age of 18, only 50-60% have been screened for
cervical cancer over the last 3 years. National rates suggest this
figure should be closer to 70%.
Aurora has worked with several organizations to increase their
cervical cancer screening rates to greater than 77%.
Colorectal cancer screening also can
significantly reduce the mortality and clinical utilization of
resources when detected early. Of individuals over the age of 50 about
15% have been screened for colorectal cancer.
Aurora has raised that rate to 43% for other groups.
The flu is a common cause of lost work/school days for adults and
children. This is especially true for older adults and individuals
with chronic disease. Appropriate flu vaccination can reduce the
incidence of flu and impact health care costs. It is suggested that
for high risk individuals, approximately $117 in medical expenses
is avoided per person for every flu vaccination.
Our medical management team for Aurora's 24,000 employees has reduced costs through the management of hospital, outpatient and specialty
care.
Aurora saved $600,000 annually though redirection, avoided hospital
days, and avoided unnecessary procedures and coordination of care with our
hospital utilization management team.
The chronic population typically accounts for 2-5% of the overall
population but they consume about 25%-30% of the health resources. They
are the individuals who have been diagnosed with chronic diseases such as
asthma, diabetes and congestive heart failure.
It has been shown that the more these people know about their disease
and the things that impact it, the less often they will require medical
care. The focus is to educate
and manage their disease.
Typical organizations have 2-3% of their population with diabetes.
Of these, only 37% had a record HbA1c (blood sugar) value in the past
year. Aurora has worked with several groups to increase the number of
people who get tested and helped lower that level from an average of
8% to 7.25%. A 1% absolute decrease in the HbA1c corresponds to a 17%
reduction in mortality, 18% reduction in myocardial infarction (heart
attack), and 15% reduction in stroke.
Every absolute reduction in
HbAic by 1% on average shows health savings worth $1000 a year.
Many individuals have coronary artery disease. Of these, 37%
have their cholesterol levels tested. Cholesterol is important to
measure and manage because of the direct relationship to heart
attacks, angioplasty and heart surgery required. Aurora has worked
with several groups and reduced the average cholesterol (LDL) level by
9%.
This translates into a 12% reduction in major coronary events
over a one-year period of time.
Most companies have cases that wind up costing more than
$100,000. Our catastrophic case managers handle these situations and have
helped Aurora avoid costs in excess of $1 million per year.
In addition, companies have individuals with multiple
co-morbid conditions such as cardiovascular disease and renal disease along
with diabetes and pulmonary disease. These individuals are likely to
incur significant expenses on an annual basis. Our community-based case
managers supervise these cases. In a sample of 45 patients in the Aurora
patient population who were managed in this fashion, we spent 38% less.
That
translates into a $1.4 million cost reduction to the plan for these 45
members.
