Surgery Quality Analysis & Blind Spots

Lowering healthcare costs while increasing surgery quality? Sounds impossible. But with the right insight into surgery quality and action, it’s entirely possible.

To get your no-cost assessment, contact Goldfinch Health today!

When it comes to providing the best in medical benefits, it’s easy to have blind spots to where those services could be improved. We developed a new tool, our Surgery Quality Analysis, to shine a light on those areas we often don’t see.

Discovering The Level of Surgery Quality

“The best vision is insight.”

The quote—attributed to entrepreneur, Malcolm S. Forbes, of Forbes magazine fame—rings true in many parts of life. And it most certainly resonates if you’ve ever been in the position of an HR, insurance, or benefits professional staring at thousands of lines of medical codes or pharmacy claims…and trying to make sense of it.

How do you find information needles in the haystack of data? And, when you do, how do you put that information to work? It can be a daunting task.

Our Surgery Quality Analysis

That is exactly why we developed the Surgery Quality Analysis by Goldfinch Health. We process medical and pharmacy claims from the previous one to three years. After analyzing the data, we create a brief summary. This includes areas to watch and opportunities for improvement. The impact can be profound as surgery is one of the highest-cost areas of healthcare and has the biggest impact on employee productivity.

These reports include assessment of

  • Outpatient vs. inpatient procedures, highlighting a potential 40+ percent cost savings and how to get there.
  • Large incision or open surgery vs. minimally-invasive surgery approaches and the impact on surgery quality.
  • Opioid use post-surgery. No matter what you’ve heard from your health plan, PBM or state legislators, opioids are still hurting our country and our workers.
  • Surgical complications compared against industry benchmarks.

The Urgent Insight Revealed

The picture that often emerges is one of not only opportunity but urgency. For example, we recently reviewed a population that showed, in the midst of Covid-19:

  • 18% reduction in major musculoskeletal procedures (back, hips, knees, shoulders)
  • And a 25% increase in steroid injections into joints

Of course, this means members in this population have put off surgery. But, in the end, most of those cases are inevitable. There will be a knee replacement or shoulder procedure needed. Due to the time, stress, and treatments that have occurred in the meantime, those members will report for surgery with diminished physical and mental health. It truly is a powder keg waiting to blow.

Another group believed strides had been made related to opioid use. A deeper look at the data revealed progress had been made—but not in the area of post-surgery opioid use, where painkiller use remained 3 times higher than national guidelines recommend.

Surgery often touches more than 60% of high-cost claimant cases. Insights into surgery quality provide the vision to act before healthcare and productivity costs overwhelm your budget.

To get your no-cost assessment, contact Goldfinch Health today!

Protect your people. Protect your plans with Goldfinch Health.