MedSolutions: Accurate Diagnosis Is Critical To Reducing Healthcare Costs

Main Category: Medical Practice Management
Article Date: 03 Jun 2009 - 1:00 PDT

email to a friend   printer friendly   view / write opinions   rate article

MedSolutions, a leading provider of medical cost management services, will highlight its groundbreaking solution - Premerus(SM) Diagnostic Accuracy - during America's Health Insurance Plans (AHIP) Institute 2009. An industry first, Premerus is a nationwide program that dramatically reduces healthcare costs and improves patient care by leveraging the proven advantages of subspecialist expertise to increase diagnostic accuracy.

Scheduled for June 3-5, 2009 at the San Diego Convention Center, AHIP Institute will bring together thousands of healthcare professionals to discuss the issues and share solutions surrounding much-needed reform in the healthcare industry. MedSolutions will join in that conversation by demonstrating how accurate diagnosis is central to healthcare reform. MedSolutions can be found at booth 304.

"Improving diagnostic accuracy is central to improving the U.S. healthcare system, and that starts with making subspecialization a priority in the radiology field," said Curt Thorne, CEO of MedSolutions. "A wrong diagnosis leads to a wrong treatment, resulting in unnecessary and significant costs for the healthcare system, as well as profound anxiety and distress for patients and their families. Our savings methodology, which is validated by Thomson Reuters, demonstrates that using subspecialist radiologists can yield millions of dollars in annual savings for payors. More importantly, it leads to patients more quickly getting the care they need."

An independent analysis has conservatively estimated that payors can realize savings of $4.45 PMPM through Premerus by employing expert subspecialist radiologists in the accurate diagnosis of disease. Premerus ensures that each patient who undergoes a high tech imaging study is matched to a Certified Premerus Expert, who is a credentialed subspecialist for the relevant anatomic area or organ.

As an example, through Premerus, a brain scan would be read by a neuroradiologist as opposed to a general radiologist - just as a patient would go to a neurosurgeon versus a general surgeon for brain surgery. The subspecialist is selected based upon his or her expertise - independent of the patient's time zone or location - giving any patient, anywhere access to leading diagnostic excellence.

The Premerus workflow is accomplished through MedSolutions' unique technology platform, which seamlessly transfers studies to the most appropriate expert radiologists based on specialization and experience. The subspecialist makes a timely interpretive report which includes quantitative and qualitative observations (such as the size, density, margin characteristics and location of a tumor) that are essential to making the best treatment decisions. The referring physician receives the report and can contact the Premerus Expert to clarify the findings or ask further questions.

Subspecialty, like that provided through Premerus, has proven to significantly improve the error rate of misdiagnosis. A 2002 study showed that mammographic breast cancer detection rates were more than 75 percent higher among breast imaging subspecialists versus general radiologists. In addition, the subspecialists had over 75 percent greater accuracy in detecting lower stage, less advanced breast cancers. Early stage breast cancer diagnosis has been associated with higher survival rates and much lower treatment costs.

A recent study by the Journal of the National Cancer Institute also found that while some physicians failed to identify breast cancer 71 percent of the time, those who specialized in reading only mammograms had an error rate of just 3 percent. In March 2009, a commentary in the Journal of the American Medical Association (JAMA) highlighted the need for greater focus on the issue, reporting that unrecognized or unreported diagnostic errors cause up to 80,000 hospital deaths a year.

"To date, little attention has been given to the issue of misdiagnosis in the U.S.," said Gregg Allen, M.D., chief medical officer for MedSolutions. "This is despite the fact that diagnostic error results in $17-29 billion annually and causes untold preventable patient harm. As an industry, we need to make increased diagnostic accuracy a priority. We can't simply stand by and continue to overlook an issue that can be solved and, furthermore, could cure many of the woes the healthcare system is currently suffering."

About MedSolutions

Using independently validated savings methodologies, MedSolutions specializes in intelligent cost management of medical services for commercial, Medicare and Medicaid payors. The company maintains management contracts for more than 25 million individuals nationwide. Using robust data, predictive intelligence technology and clinical expertise, the company's innovative solutions extend beyond radiology management to other areas of medical specialty, including cardiology, oncology, ultrasound, emergency room and Premerus(SM) diagnostic accuracy. MedSolutions has been twice recognized for its Call Center operations by the prestigious J.D. Power and Associates Award.

Source: MedSolutions