FAQs

Hospitalization Reduction & How Concierge Medicine Is Saving $$$

JANUARY 20th, 2011 – Independent analyses show clearly that concierge-models deliver superior clinical outcomes compared to conventional insurance-based practices. This is independent of the age, disease burden, or socioeconomic status of the patients. “When you have time to deal with the issues, you do better,” Dr. Lee stressed.

One recent study compared MDVIP practices in Florida with HMO-based practices in that state. The MDVIP doctors achieved an average total HEDIS compliance of 89.6%. The average for the top-performing 10% of HMO practices was 65%.

$79 Million Saved

A third-party evaluation of 2008 data showed that MDVIP patients had 61.3% fewer hospitalizations compared with similar patients in commercial insurance plans, and 74% fewer hospitalizations compared with Medicare patients of similar age, gender, and disease risk.

Plain and simple, MDVIP hospital utilization rates are lower, even when matching for demographic variables. In 2006, MDVIP practices had an average total hospitalization rate of 119.24 admissions per 1,000. In non-MDVIP matched practices, the rate was 226.5 per 1,000. On average, MDVIP patients had 107 fewer admits per 1,000 than people in standard insurance plans, a 47% reduction.

The Centers for Medicare & Medicaid Services lists conditions for which patients should never need hospitalization, among them: Uncontrolled Diabetes, Uncontrolled Hypertension, Decompensated CHF; Decompensated Asthma; Cellulitis; Community Acquired Pneumonia; Pyelonephritis; and Perforated Appendix.

The data show that preventable hospitalizations are lowered by 40% in MDVIP practices. MDVIP’s avoidable hospital rates average 16.6 admissions per 1,000 people. In standard insurance plans with comparable patient populations, the rate is 27.5 admits per 1,000. MDVIP’s hospital discharge rate in 2007 was roughly 105 per 1,000 members, versus 199 per 1000 members in standard insurance plans. Dr. Lee estimates that at its current small size, MDVIP is already eliminating over 9,000 hospitalizations per year, saving roughly $79 million in total health care expenditures. “This is such a beneficial program for the government!”

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