Holistic healthcare benefits can cut down surgery spend

Undergoing surgery is stressful — dealing with treatment costs, administrative work and follow-up care shouldn't be. But with a single point solution, employers can procure a more streamlined experience for themselves and their workforce.

Healthcare navigation and care coordination platform Quantum Health has expanded its partnership with Centers of Excellence platform Carrum Health, bringing holistic surgery support to its three million members. A Center of Excellence is a group that has a proven record of best practices in a specific area of care. Employers can now choose to add this option to their existing Quantum offerings, putting Carrum's bundled surgical care alongside the rest of their employees' healthcare benefits. Consolidating everything workers need for their surgical process can lead to lower costs, improved communication among all of their care providers and better overall health outcomes, says Dan Shur, Quantum's chief product officer.  

"Carrum has reimagined the surgical bundle," he says. "It's already pre-packaged for the employer, and by getting people into high-quality doctors, there's going to be a savings. There's also going to be a better experience for their employees and their dependents. But that's only one piece of the puzzle; surgical episodes happen amidst a whole bunch of other things, and that's why if you marry the navigation with the surgical pieces, you actually have a complete solution."

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There has been an increase in surgeries as employees have started to schedule the elective and non-emergency operations they put off during COVID, such as musculoskeletal, cardiovascular and bariatric procedures. A survey from Carrum Health and Employer Health Innovation Roundtable found that 34% of employers' overall spend is going toward surgery costs — something many are looking to reduce by signing on with Centers for Excellence, which Shur notes use a value-based care model rather than a fee-for-service structure. 

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Reduction in spending is a critical consideration for employers as they face aging workforce populations who will need some of the most common surgeries in the near future: Knee replacement surgery, for example, costs $35,000, an angioplasty averages $28,200 and a spinal fusion will run $110,000, according to Debt.org. Avoiding unnecessary procedures and reducing incidents of readmittance to the hospital are some of the benefits of seeking out Centers of Excellence. Quantum's care coordinators help members avoid additional, unnecessary expenses that can stem from having too many point solutions or complicated benefits systems.

"We strive to get people the right care, whether that's [the right] specialty, in-network versus out-of-network, cost, location or even [doctor] preference," Shur says. "Our goal is better clinical outcomes, saving both the patient and the employer money in the process."

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In addition to helping employees find the best surgical options, Quantum's care coordinators can also assist patients and their families with the care needed before, during and after a surgical procedure. Everything from wellness and behavioral health offerings for emotional support to post-surgery physical therapy and caregiving assistance for patients' children during recovery is available through Quantum's platform.  

"We're working with patients and their families," says Shur. "Carrum picks up where Quantum leaves off, and then Quantum picks up on the far end of that. That way, we continue to help the patients with what they need."