What They’re Watching: Mark Stadler, BridgeHealth
“We’re looking at cost and quality issues and the disparity and lack of correlation between cost and quality across the United States and across providers. What we find is that the correlation between cost and quality gets lost. Providers that are able to deliver some of the highest quality are actually doing it at the lowest cost because they have perfected the surgery, they’ve perfected the procedure, and they’ve built whole hospitals and organizations around those. Specifically, things like total knee replacement, total joint work, and things like that.
The story about a customer of ours, a very large employer, in a 12-month period they did approximately 100 total knee replacements within their employee population. Eighty of them came through BridgeHealth — and my company guides members into high-quality cost-effective solutions for surgeries that can be scheduled. Of those 80 surgeries we had zero complications with the patients. They returned to full functionality and, you know, great personal performance after that. There were another 20 surgeries that didn’t come through BridgeHealth and of those 20, eleven of them had complications that cost the plan sponsor $750,000 to repair the complications. And this is the real issue around quality; that if a person is having a surgery in the wrong center, it’s done improperly, the ramifications in terms of infection or having to revise the surgery, are extremely expensive and that cost is borne by the health plan and in this case by self-insured employers who are paying the bill.”