minimizing medicare mayhem
DESCRIPTION
Medicare is on a collision course... there are things we can do about it.Using the latest technology in telephone triage, wasteful medicaid spending can be massively reduced.Working together, we can solve problems our elected leaders have not been able to solve.TRANSCRIPT
Minimizing Medicaid Mayhem
Presented by Nexus Alert
Where Are We Now?
Medicaid spending grew 9.0% to $373.9 billion in 2009 and will average 7.9% per year through 2019
Current projections show Medicaid spending to top $800 billion by 2019
Estimated $7 billion spent on Medicaid patients utilizing hospital ED for non-emergency purposes
How Did We Get Here?
Medicaid reimbursements to primary care docs were reduced to below office overhead costs
Primary care docs stopped taking new Medicaid patients
In 1986, a law required all emergency rooms to see all patients regardless of ability to pay
New Medicaid patients began to use hospital ER as primary care office visits
Why The Increase In Medicaid? No access: Primary Care “office visit”
cost $80 Open access: ER “office visit” cost:
$651 (in 2008)
With no lower cost options, Medicaid patients began using the ER as a PCP office for non-urgent care 166% higher for Medicaid Patients than
private insurance in 2008
How Do We Fix It
Nurse Triage Utilization reduced ER usage by 66% (according to a 2007 study in Texas)
PROBLEM: Nurse Triage Hotlines have a utilization rate near 1%
SOULTION: New technology from Nexus Alert creates 15% utilization.
Projected Results
Medicaid patients using hospital ED for non-urgent needs ($7 billion)
Telephone Triage shows 66% reduction in ED over-utilization by Medicaid patients for non-urgent needs
15% Utilization rate with Nexus Nurse Care
$693 Million in savings to Medicaid
Now What?
If you want to help to me minimize Medicare expenses, forward this presentation to Medicaid employees in your state.
Tell them to ask about setting up a pilot program to learn how effective Nexus Nurse Care can be.
Together, we can make a difference!
