MD PRACTICE PATTERN VARIATION Las Vegas

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MD PRACTICE PATTERN VARIATION Las Vegas

• HEREIU Fund
• Elizabeth B. Gilbertson
• Chief of Strategy

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Overview Las Vegas HEREIU Fund2003

• Number of lives 120,000
• Total annual medical spend 235 million
• Demographics
• Low income immigrant population
• 43 Latino 13 Asian 10 African American
• All located in Southern Nevada
• 1,800 physicians in network
• All doctors in the same specialty paid the
  same rates
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MD Network Restructuring Project2003

• Profiled all physicians in the network for
  efficiency
• Utilized software with clinical indicators to
  profile for quality
• Restructured based on
• Practice patterns
• Geography
• Language culture
• Sub-specialty
• Terminated 50 doctors 3

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Four Episode Treatment GroupsHow the Costs
Vary1. Ear Infection Family Practice
412
SPECIALTY AVERAGE
109
46
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Four Episode Treatment GroupsHow the Costs
Vary2. Acute Bronchitis Family Practice
771
SPECIALTY AVERAGE
150
89
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Four Episode Treatment GroupsHow the Costs
Vary3. Urinary Tract Infection Internal
Medicine
778
SPECIALTY AVERAGE
140
81
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Four Episode Treatment GroupsHow the Costs
Vary4. Knee Joint Derangement Orthopedic
Surgery
9,383
SPECIALTY AVERAGE
4,473
2,727
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Medical Cost Savings
67M
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Sources of Savings (26 Million)
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ResultsWorker Raises 50,000 workers

• Average wage 13/hour
• Average raise 60 cents/hour each
  year for 2 years

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Results Medical Cost Control

• Average medical trend increase
• 2003 -2010

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