Amputations
We spend $8 billion dollars a year on amputations, and the average amputation costs over $100,000…
[R]oughly twenty percent of diabetic patients will develop ulcers on their legs and feet, and … twenty percent of those ulcers currently turn into amputations… The current pattern for all Medicare patients is for 20% of those ulcers to require a complete amputation—giving us the highest rate of amputations in the western world—and the current pattern for Medicare Advantage patients is to have under 5% of those ulcers to go down that path.
Congestive Heart Failure
[C]ongestive heart failure crises range from $20,000 to $40,000 for each patient and when the plans assign a nurse or a care team to each patient to look for the early signs of a crisis, the average plan can reduce the crisis levels for their patients by 40% or more… The plans often put accurate and easy to use and see weight scales in the patient’s homes to look for sudden weight gain. Some of those scales have telephone connections to give very quick warning to the care team to intervene when that weight gain happens.
Fee for service Medicare does not provide that resource or even allow those nurses to bill Medicare for that care if someone puts them in the patient’s homes. It can actually be fraud to bill Medicare for a nurse detecting that weight gain.
Emergency Room Visits:
Medicare Advantage plans tend to end up with about 35% percent lower uses of emergency room visits.
Full article at The Health Care Blog.