Connecting patients with the highest quality care available to them saves both lives and money. This is the premise behind the proprietary algorithm healthcare technology company Grand Rounds extends to brokers and advisers to provide for clients in order to combat misdiagnoses and improve healthcare literacy.

The approach provides patients with either a remote expert opinion, personalized match with a leading local physician for in-person care, or in-hospital treatment decision support. Members access these services through the Grand Rounds web-based portal, mobile app, or by calling the company’s care team.

Bloomberg/file photo

Based on various patient surveys, Grand Rounds recommends spending an average of 40 minutes on the phone with patients to explain their diagnoses versus just 16-minute averages for in-person visits to assure they’re seeing the most qualified specialist.

This doubles a patient’s clinical understanding of his or her condition to about 90%. As a result, they’re able to find less invasive options from a network of world-class physicians, as well as quell any anxiety associated with navigating such a complex system.

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A second opinion can “add comfort and reduce excess cost for health plan members accessing the healthcare system,” according to Vanessa Longnecker, SVP of national strategic development for Hays Companies, one of several brokerages that offer this solution to both their employees and clientele. Connecting patients with the highest quality physicians available really ensures they’re getting a best-in-class specialist who’s dedicated to the unique needs of each member.”

Securing the right care for complex and costly surgeries and treatments is critically important, considering 10% to 20% of the most at risk drive nearly 80% to 90% of the cost, Longnecker says.

“Expert opinions are ideally suited for complex, high-risk, high-severity cases where patients have already seen a number of doctors,” says Nate Freese, senior director of data strategy at Grand Rounds, Inc. He says common decisions include whether or not to undergo surgery or take biologic drugs that cost hundreds of thousands of dollars a year.

Launched in 2011, Grand Rounds reaches more than 80 largely self-insured employers with three million covered lives and generally charges a per employee, per month price. He describes the company’s approach as a simple way to identify the best doctor within a given provider network.

Sizeable results
It’s among a handful of highly specialized advocacy transparency toolsets that align with driving the mission of brokerage clients, which include the workforce at Hays, one of the fastest-growing privately held risk-management insurance and employee benefit advisers nationwide. The company has more than 800 professionals at more than 35 locations.

“People are our biggest asset, and our investment in, and partnership with, Grand Rounds furthers the message around how much we truly care about our people,” says Longnecker when asked about the arrangement’s extension to Hays employees.

She says “very sizeable results” have been achieved at Hays over the past 18 months “not only in the form of immediate return on investment, but we’ve had over 50% of our employees engaged within the tool set and more than 200 cases completed in the first year.”

ROI across Hays’ broader book of business using Grand Rounds has seen anywhere from a 1.6:1 to 5:1 ROI, while dually benefiting from enhanced employee satisfaction, appreciation and productivity that enable employers to improve the bottom line from a claims perspective and holistic risk-management approach, Longnecker says. In addition to driving utilization, the tool is embedded into Hays’ internal employee benefits mobile app, as well as its proprietary analytics engine as an opportunity to improve and track results.

Andrea Field, national director of marketing and strategy at Hays Companies, notes the potential to help recruit and retain talent. She says the service “really adds some value” to having a robust employee benefits package “in a way that is different than other offerings.”

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