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Expert Medical Opinion Program

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Presentation on theme: "Expert Medical Opinion Program"— Presentation transcript:

1 Expert Medical Opinion Program
Make access to exceptional care easier

2 The HIGH cost of diagnostic and treatment errors
Up to 36% of diagnoses are delayed, missed or wrong. Diagnostic errors account for almost $40 billion in annual insurance claims Up to 4 in 10 conditions Are misdiagnosed or mistreated 28% of overall medical care is not needed. Sources: Up to 36% of diagnoses are delayed, missed or wrong. Berner ES, Graber ML. Overconfidence as a cause of diagnostic error in medicine. Am J Med. 2008;121(5 Suppl):S2-23. Singh H, Giardina TD, Meyer AN, et al. Types and origins of diagnostic errors in primary care settings. JAMA internal medicine. 2013;173(6): 28% of overall medical care is not needed, including about a quarter or tests, more than a fifth of prescriptions and more than a tenth of procedures. Lyu, Heather Xu, Tim, et al. Overtreatment in the United States, PLOS One, September 6, 2017 Diagnostic errors account for almost $40 billion in annual insurance claims. Johns Hopkins Medicine Up to 4 in10 conditions are misdiagnosed or mistreated. Elizabeth A. McGlynn, PhD; Steven M. Asch, MD, MPH; et al. "The Quality of Healthcare Delivered to Adults in the United States," New England Journal of Medicine2003;348:

3 17+ years The right partner for expert medical opinions world-class
Advanced data analytics and multi-channel communications Access to world-class specialists, academic centers and Centers of Excellence Cost of remote opinions included in program fee 17+ years of experience navigating the healthcare system and locating the right quality specialists for second opinions (in-person and remote) Expert medical opinions fully integrated with comprehensive health advocacy service (clinical + administrative) End-to-end support & seamless member experience Expanded eligibility: employees, spouses, dependents, parents and parents-in-law

4 National Network of Leading Academic Centers & Centers of Excellence

5 High touch guidance to the right care and treatment
Unlimited access to Health Advocate’s clinical team. End-to-end care coordination Ongoing collaboration with members’ treating physicians Ongoing treatment decision support Pre-visit testing Post-appointment follow-up

6 One call or click finds the right high-quality, in-network experts
Thorough clinical intake including medical history and treatments to date Rigorous, detailed search of specialists, Academic Centers and Centers of Excellence nationwide Contact providers and make appointments Transfer medical records Ongoing follow-up support

7 State-of-the-art data analytics sends the right messages at the right time
Communications, including a mailing and raffle, to promote online registration Push notifications and reminders help promote second opinions Ongoing promotional materials (including outbound s) This slide applies only to data clients who have 5,000+ EEs

8 Backed by complete health advocacy support
We’ll save employees time, money and worry Avoid costly mistakes by clarifying benefits and out-of-pocket costs Alleviate uncertainty by explaining medical conditions, treatments and tests Save money by reviewing medical bills and resolving claims and billing issues

9 Comprehensive Reporting
Utilization Reports Awareness mailings Registrations Outbound personalized communications Cases by condition and provider type Reason for EMO Changes in diagnosis Changes in treatment plan Return on Investment (ROI) Reports Cost savings from treatment plan changes Cost differences between updated vs. original plan (including cost of procedures member did not receive; reduced productivity; complications)

10 Thank You First Name, Last name Title on second line 000. 000
Thank You First Name, Last name Title on second line or


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