Transcarent partners with Hospital for Special Surgery to provide access to care
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Transcarent announced a new collaboration with Hospital for Special Surgery that will allow employees of self-insured employers and their families access to the hospital’s orthopedic and musculoskeletal specialists.
Through the collaboration, employees of self-insured employers and their families will have limited or no out-of-pocket responsibilities, with Transcarent handling all member referrals and covering the cost of certain orthopedic surgeries, along with travel coordination and associated costs when necessary, according to a company press release.
“Through this important collaboration, [Hospital for Special Surgery] HSS and Transcarent will help employers reduce health care costs and improve the care experience for their employees,” Louis A. Shapiro, president and CEO of HSS, said in the release. “It is a new opportunity for HSS to apply the world’s largest concentration of orthopedic expertise to enable people, businesses and communities to realize their potential.”
The release noted Transcarent provides personalized health and care support through dedicated health guides for most common and challenging needs, including urgent care, lower-cost medications, personalized behavioral health, care at home, cancer treatment and expert second opinions.
“Leading employers remain dissatisfied with the access to, quality of and cost of our health care system, especially the surgery experience for their employees and their families,” Glen Tullman, CEO of Transcarent, said in the release. “HSS has long been the acknowledged industry leader in orthopedic care, and we are excited to collaborate with them to bring the Transcarent experience with surgery care to people across the nation who need high quality, affordable care.”
Reference:
Hospital for Special Surgery joins with Transcarent to provide leading self-insured employers with a new health and care experience for employees. https://www.businesswire.com/news/home/20220818005224/en. Published Aug. 18, 2022. Accessed Aug. 25, 2022.
Perspective
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The future of health care is about patient control. Companies are using vehicles like "care coordinators" to manage their patient population instead of relying on the health system to administer their care. A digital connection using nurse answering services and/or other paraprofessionals is clearly on the rise. Two main issues that are critical are obtaining an accurate diagnosis and receiving appropriate high-quality care. Utilizing physical therapy, care coordinators and/or chiropractic care, in my opinion, without objectifying the diagnosis can be extremely expensive for an employer. It appears that a relationship with a high-quality academic orthopedic group is of benefit, but what is the cost of care? Is it saving the employer money and/or is the additional preventative care really cost-effective? Having reviewed hundreds of claims from groups offering value-based musculoskeletal solutions, it is always of interest to see what the actual cost for a specific diagnosis is. For example, in a patient with end-stage knee osteoarthritis requiring total knee replacement, cost of care (including bundled pricing) ranges anywhere from $19,000 to $50,000 in our area with comparable clinical results and complication rates. Structured physical therapy, in attempts at reducing the need for surgery, can be as high as $10,000. In patients with early knee OA, do structured, multiple, physical therapy visits provide any benefit or would a home physical therapy program coupled with NSAIDs, and occasional intra-articular injections provide the same results? Does a high-quality academically structured program afford a better clinical experience than a local value-based orthopedic group with low complication rates? At the end of the day, what is the total cost of care and is the selected group providing better outcomes? The ability to view claims and gather data to measure outcomes and complication rates will tell the story.
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