Presented on Thursday, October 14, 2021
A study by Medical Review Institute of America (MRIoA) revealed that more than 45% of surgeries certified through the Prior Authorization process were not the next best step in a patient’s healthcare journey when reviewed by an independent specialist. During a recent study1 at Mayo Clinic, as many as 88% of patients (286 total patients) looking for a second opinion received a new or refined diagnosis. This validates one of the many reasons behind the phenomenal growth of the second opinion market – primarily driven by payers and self-insured employers trying to control staggering healthcare costs.
On October 14, 2021, HCEG’s Executive Director Ferris Taylor and leaders from MRIoA, Bob O’Brien, Executive Best Care Business Unit and Dr. Rodney Musselman, Executive Medical Director-Utilization Management Solutions discussed the above and more about offering virtual 2nd opinions including:
- How 2nd opinions provide additional value and benefits to plan members
- Why alternative treatment options are important to member engagement and costs to both the member and health plan
- How using 2nd opinions can optimize medications and positively impact member health at lower overall cost
- Understanding the risks and recovery implications with respect to the initial diagnosis and alternative treatments
- How health plans and self-insured employers can save money by offering virtual 2nd opinions for high-cost/high-risk procedures
- Gain insight into potential Returns on Investment (ROI) associated with virtual 2nd opinions
Watch the recording of this presentation to hear how your organization can use virtual 2nd opinions to improve member engagement and help decrease costs. And reach out to [email protected] for additional information.
1. VeryWell Health, March 28, 2020, https://www.verywellhealth.com/top-reasons-to-get-a-second-opinion-4144734
|Ferris Taylor||Bob O’Brien||Dr. Rodney Musselman|
|Executive Director – HCEG
||Executive Best Care Business Unit – MRIoA||Executive Medical Director
Utilization Management (UM) Solutions – MRIoA
|Prior to becoming Executive Director at HCEG, Ferris served as COO of Arches Health Plan in Salt Lake City, Utah. Ferris founded Pragmatic Health Care Solutions, a healthcare strategy and market positioning firm, served as VP of Payer Market Strategy at Optum, VP Marketing and Planning at Partners Healthcare, and head of Marketing Information Services at Harvard Pilgrim Health Care.
Ferris is a BYU graduate in Nuclear Physics with an MBA in finance and quantitative economics.
Bob has more than 30 years of sales and marketing experience with numerous achievements in the development of new markets and repositioning of products and services in healthcare. Prior to joining MRIoA he held roles at CVS Aetna, Grand Rounds, and ActualMeds.
Bob holds a bachelor’s degree from Assumption College and a Master’s in business administration from The University of Connecticut.
Rodney joined MRIoA as a medical director in May 2013. In 2019, Rodney transition to the role of Executive Medical Director – UM Solutions & Sales. He provides clinical oversight and guidance to assist with the growth of the organization.
Rodney completed his undergraduate and medical training at Indiana University and became board certified in Family Medicine in 2003.