Las Vegas Healthcare Network Restructuring: Efficient Care Delivery
A case study of the makeover project in a Las Vegas healthcare network aiming to improve quality, control costs, and streamline services. Learn about the restructuring process, cost variations in treatment groups, and significant medical cost savings.
Las Vegas Healthcare Network Restructuring: Efficient Care Delivery
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Presentation Transcript
MD PRACTICE PATTERN VARIATION Las Vegas HEREIU Fund Elizabeth B. Gilbertson Chief of Strategy
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
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
Four Episode Treatment GroupsHow the Costs Vary1.Ear Infection – Family Practice $412 SPECIALTY AVERAGE $109 $46 4
Four Episode Treatment GroupsHow the Costs Vary2. Acute Bronchitis – Family Practice $771 SPECIALTY AVERAGE $150 $89 5
Four Episode Treatment GroupsHow the Costs Vary3. Urinary Tract Infection – Internal Medicine $778 SPECIALTY AVERAGE $140 $81 6
Four Episode Treatment GroupsHow the Costs Vary4. Knee Joint Derangement – Orthopedic Surgery $9,383 SPECIALTY AVERAGE $4,473 $2,727 7
Medical CostSavings $67M 8
Results:Worker Raises50,000 workers • Average wage: $13/hour • Average raise: 60cents/hour each year for 2 years 10
Results: Medical Cost Control Average medical trend increase: 2003 -2010 6% 11
