In 2006, MedSolutions implemented Medicaid’s first radiology benefits management (RBM) program. Today, we’re the leader in Medicaid experience, offering not just RBM but a wide range of medical cost management programs addressing everything from radiation therapy to spine surgery.
Our company partners with a number of state and commercially managed Medicaid payers, serving more than 11 million Medicaid beneficiaries. We fully understand the complex issues within Medicaid, including shifting in aid categories and dual eligibility, as well as the opportunity for fraud and abuse that compromises patient safety and drives up costs.
At MedSolutions, our belief is that better healthcare is inherently less expensive. That ability to improve care for patients while lowering costs will only become more important as Medicaid enrollment expands under the Patient Protection and Affordable Care Act. According to the Kaiser Family Foundation, the expansion could reach an estimated 16 million uninsured people by 2019. What’s more, two-thirds of Medicaid enrollees now receive most or all of their benefits in managed care, and many states are expanding their use of managed care to additional geographic areas and Medicaid populations.
With the depth of our Medicaid experience, we’re uniquely positioned to meet this growing need, and our results speak for themselves. Recent Medicaid customers have seen a reduction in PMPM imaging costs of 15 to 26 percent, all while improving patient care. In one state Medicaid population, prior to the implementation of our program, dramatic over-testing put patients at risk. For example, 170 Medicaid patients received more than 11,800 imaging scans in only two years – that’s the equivalent of 70 scans per person! High-risk groups such as pregnant women, where radiation exposure may harm the mother and baby, are especially vulnerable. In one case, a Medicaid patient received 22 CT scans during her pregnancy at tremendous risk to the unborn child. Our program put an end to this dangerous and expensive level of testing, applying evidence-based guidelines to ensure patients get the right test at the right time for their diagnostic needs.
We’re excited about the many programs we offer that can improve the care Medicaid patients receive and simultaneously generate significant savings. We hope you’ll stop by booth #18 to learn more next week at the Medicaid Managed Care Congress 2013.
It's not too late to register for the 21st Annual Medicaid Managed Care Congress! To learn more, download our brochure. We hope to see you next week in Baltimore, MD!