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Edison Healthcare

Edison Healthcare

Edison Healthcare

Edison Health

**Winner of the 2019 Health Value Award for Program Provider – Specialty Destination Center of Excellence (U.S.)**

Question / Intervention Goal / Objectives  

Edison’s program send patients to high-quality providers, with the goal of correct diagnosis and efficient treatment.  Travel costs and arrangements to see the designated providers are handled by the program so that employees do not have barriers to care.   

 

Method/ Calculation  

Edison provides an online calculator that estimates, based upon an employer’s number of lives, the frequency of certain conditions and the use of the travel program.  Costs for the travel program and the care delivered by the designated providers is compared to costs for the same services from other providers. Credible sources were used for the non-program providers; in addition, the user can supply his/her own plan’s data in the calculator.  

Savings are stated net of the program fees, except for the initial set-up charges.  

 

Findings / Metric/ Outcome/ Savings  

Using credible estimates, the costs for the program’s designated providers are lower than comparable providers.  Since the fees are triggered by a member’s using the program, the employer’s risk of having higher costs is minimized.   

 

Limitations  

Participation in the program may lead to a member’s diagnosis getting changed, and therefore the care plan.  This could lead to additional savings or additional costs. This is not addressed in the savings estimates.  

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