New Data Shows Reduced ER Use and Hospital Length of Stay

FRANKLIN, Tenn., May 10, 2011 /PRNewswire/ -- MedSolutions and Corporate Research Group announced results from a groundbreaking diagnostic accuracy program that helped a major health plan reduce unnecessary ER use, hospitalizations, surgeries, medications and treatment.

Using MedSolutions' Premerus® Diagnostic Accuracy, a proven solution to the problem of diagnostic error, one major health plan reduced ER use of services by over 50 percent, shortened hospital length of stay by 1.4 days, and decreased unnecessary biopsies and surgeries by 35 percent.

Premerus utilizes technology and specialized radiologists to ensure that diagnostic tests are read by the appropriate specialist every time, resulting in a more accurate diagnosis that improves quality of care and lowers cost. As a result, patients benefit from reduced health risks of unnecessary surgeries, biopsies, treatments and medications, as well as the associated out-of-pocket savings. The health plan using Premerus also reduced total healthcare claims by 7.6 percent, saving more than $5 per member, per month (PMPM) while improving outcomes.

Often unrecognized or unreported, false negative diagnostic errors occur in up to 32 percent of cases(1) -- adding millions in unnecessary tests and treatments and driving 40 percent of all malpractice litigation.(2)  According to a recent study, preventable harm from diagnostic error exceeds that of any other medical intervention and is twice that of medication errors.(3)  

"Whether you are a commercial or Medicare Advantage health plan, a state or managed Medicaid plan, a large employer or a state retirement system, organizations charged with managing the risk of their population must find new ways to reduce cost while improving care quality and outcomes," said Norman A. Scarborough, M.D., vice president and senior medical director of MedSolutions. "Premerus is founded on the premise that an accurate diagnosis can do more to improve quality of care and reduce cost than any other intervention."

In today's highly specialized medical environment, referring a patient with a specific problem or condition to a medical specialist is a recognized best practice. However, many patients are surprised to learn that their diagnostic imaging results are typically reviewed by a general radiologist. In fact, some experts believe misdiagnosis persists because clinical best practices such as specialization, which is readily adapted in other areas of medicine, are not well leveraged in the diagnostic process.

Research has long affirmed that a physician's degree of specialization and volume of experience reading certain types of scans dramatically increase the probability of accurate diagnosis. According to a Clinical Radiology study, neuroradiology specialists were 34 percent more accurate than generalists.(4)

Premerus addresses growing cost concerns for America's payors. Nearly 90 percent of the health plan executives who participated in a recent Premerus webinar reported an increase in ER utilization among members while more than 66 percent said they had seen growth in outpatient surgeries. Participants also reported increased pharmaceutical costs. In addition to dramatically lower use of ER services, reduced hospital length of stay and fewer in-patient surgeries, latest results for Premerus show a 32 percent reduction in pharmaceutical costs.

As a comprehensive program designed to improve health quality and improve health outcomes, Premerus fits squarely into health reform requirements for medical loss ratio (MLR). To learn more about Premerus visit www.medsolutions.com/premerus or view the information presented in the webinar.  

About MedSolutions

MedSolutions specializes in quality-driven, intelligent management of medical services for commercial, Medicare and Medicaid members. Using evidence-based medical guidelines, MedSolutions' doctors and nurses provide clinical review to assure appropriateness of services, thereby improving the quality and safety of care delivered to patients. 

The company provides services for more than 33 million individuals nationwide. Using robust data, predictive intelligence technology and evidence-based clinical expertise, MedSolutions' innovative solutions extend beyond Radiology Management to other areas of medical specialty, including Oncology, Cardiac Imaging, Sleep, Ultrasound, and our groundbreaking Premerus®  Diagnostic Accuracy program -- the nation's first solution for reducing diagnostic error rates to improve the quality and safety of care. MedSolutions has been recognized for outstanding customer service and effective call center management by the International Customer Management Institute and for four consecutive years by the prestigious J.D. Power and Associates Award. Visit www.medsolutions.com.

About Corporate Research Group

Corporate Research Group has been serving the managed healthcare marketplace since 1993 as the industry's leading source for news, strategic intelligence, market research and custom consulting. CRG products consist of print and electronic newsletters, e-mail updates, annual forecasts, conferences, audio conferences, and the unique Managed Care Access online information service. Disclosure: Many leading health plans, managed care services companies and other healthcare organizations have retained CRG for specialized consulting projects and targeted information services -- including companies covered in our newsletters, reports and blog. www.CorporateResearchGroup.com

(1) Radiology 1992: 183: 145-150
(2) "What the Doctor Missed" Wall Street Journal, Sept. 28, 2010 http://online.wsj.com/article_email/SB10001424052748703694204575517834198205438-lMyQjAxMTAwMDIwODEyNDgyWj.html#
(3) Diagnostic Imaging, December 1, 2010 "To Err is Human; Analysis Finds Radiologists Very Human"
(4) Clinical Radiology 2008, 63 (7), 791-5


Contact: Rebecca Kirkham
Lovell Communications Inc.
(615) 297-7766

SOURCE MedSolutions

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