The Risk of Costly Suboptimal Surgery Has Never Been Greater
The Risk of Suboptimal Surgery Has Never Been Greater (due to Covid-19)
Thankfully, rays of sunlight have appeared through the darkness of the Covid-19 pandemic. As life returns to “normal,” healthcare no doubt will resume traditional patterns as well.
This leaves business, employee benefits and human resource leaders facing critical questions, including:
- How do I help my people safely find their way through healthcare in the “new normal”?
- What can I do to ensure the coming onslaught of delayed care doesn’t reset healthcare expenses at a higher trajectory for years to come?
Healthcare spending experienced a historic decline year-over-year from 2019 to 2020, driven by delayed care. Because of coronavirus-related fear and anxiety, many people avoided doctors’ visits, screenings (by the hundreds of thousands) and prescriptions. In addition, government mandates restricted access to care.
Thousands of surgeries have been placed in a holding pattern. In the second quarter of 2020, it was reported knee replacements were down 68%, hip replacements were down 52% and cancer surgeries were down 18%, compared to 2019.
The postponement of surgical care means a prolonged surge is coming. One estimate suggested there will be a backlog of more than 1 million surgical cases two years after the end of Covid-caused elective-surgery deferment. This isn’t going away anytime soon. At stake? Billions of dollars in 2021 and beyond.
Surgery—integral to cancer, musculoskeletal and many other areas—is among the highest-cost areas of healthcare. In the coming months, patients will enter surgery pathways, in many cases, in worse condition than they found themselves pre-pandemic. Cancer has advanced, joints have deteriorated, and perhaps even physical conditioning and mental health have suffered during the pandemic. What would have been routine 12 months ago may no longer be.
Combine this with a pressure to deliver care by healthcare providers looking to make up lost revenue and you have the perfect formula for poor outcomes, both clinically and financially.
If healthcare expense resets higher, it will be due, in large part, to suboptimal surgery. These are invasive procedures that come with heavy doses of opioid painkillers, complication risks and long recoveries. Outdated by decades, these surgeries occur much-too frequently today. One estimate places the prevalence of suboptimal surgery at 95% of all common procedures.
As a business, employee benefits or human resource leader, what can you do? There has never been a better time to invest in surgery navigation and care management to ensure your organization’s healthcare cost curve doesn’t follow the industry trend. Existing general benefits navigation programs, as well as centers of excellence and other narrow surgical networks, fall far short of what is needed today for your employees and for your company.
Goldfinch Health offers an innovative program that works within existing insurance networks to help ensure people never receive a suboptimal surgery. The Goldfinch Surgery Experience is different from other solutions in three ways:
- Access to Enhanced Surgical Pathways fast-tracks members to recovery, minimizes the need for opioids and lowers the risk of infection and reoperation.
- Guidance from a Goldfinch Nurse Navigator safeguards members and ensures there are NO “I wish I had knowns” throughout the surgery and recovery process.
- A focus on outcomes that matter. Saved Days in returning people to work and life is the primary metric of success.
Goldfinch helps to get your people to the right place in the healthcare system for high-quality care. Then, we set them up to get out and back to their normal lives as soon as possible. Guaranteed. This is always right for your people, but it is especially right during a pandemic.
To learn more about how Goldfinch Health can help, start your journey today.
Protect your people. Protect your plans with the Goldfinch Surgery Experience.