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MD PRACTICE PATTERN VARIATION Las Vegas

MD PRACTICE PATTERN VARIATION Las Vegas. HEREIU Fund Elizabeth B. Gilbertson Chief of Strategy. Overview: Las Vegas HEREIU Fund 2003. Number of lives: 120,000 Total annual medical spend: $235 million Demographics Low income immigrant population

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MD PRACTICE PATTERN VARIATION Las Vegas

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  1. MD PRACTICE PATTERN VARIATION Las Vegas HEREIU Fund Elizabeth B. Gilbertson Chief of Strategy

  2. Overview: Las Vegas HEREIU Fund2003 • Number of lives: 120,000 • Total annual medical spend: $235 million • Demographics • Low income immigrant population • 43% Latino; 13% Asian; 10% African American • All located in Southern Nevada • 1,800 physicians in network • All doctors in the same specialty paid the samerates 2

  3. MD Network Restructuring Project2003 • Profiled all physicians in the network for efficiency • Utilized software with clinical indicators to profile for quality • Restructured based on • Practice patterns • Geography • Language & culture • Sub-specialty • Terminated 50 doctors 3

  4. Four Episode Treatment GroupsHow the Costs Vary1.Ear Infection – Family Practice $412 SPECIALTY AVERAGE $109 $46 4

  5. Four Episode Treatment GroupsHow the Costs Vary2. Acute Bronchitis – Family Practice $771 SPECIALTY AVERAGE $150 $89 5

  6. Four Episode Treatment GroupsHow the Costs Vary3. Urinary Tract Infection – Internal Medicine $778 SPECIALTY AVERAGE $140 $81 6

  7. Four Episode Treatment GroupsHow the Costs Vary4. Knee Joint Derangement – Orthopedic Surgery $9,383 SPECIALTY AVERAGE $4,473 $2,727 7

  8. Medical CostSavings $67M 8

  9. Sources ofSavings($26 Million) 9

  10. Results:Worker Raises50,000 workers • Average wage: $13/hour • Average raise: 60cents/hour each year for 2 years 10

  11. Results: Medical Cost Control Average medical trend increase: 2003 -2010 6% 11

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