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The Regenexx Corporate Plan has helped employers reduce the overall expense category of one of the top major diagnostic categories (MDC). We do this by offering a program that gives employees access to non-surgical treatments that replace 70% of what was previously only treated with surgery.*

The standard of care is what a reasonable physician would consider to be prudent and necessary to treat a particular condition. The standard of care evolves in every field over a period of time, but there is an inherent tension when a new technology evolves that displaces an old standard. That old standard has staunch defenders and adherents.

In the past, orthopedic surgeries were deemed the standard as no other option in care existed. Today, with the arrival of alternative choices and innovation in treatment options, many orthopedic surgeries should be the last step in prudent medical care as more conservative options are becoming the standard of care.

* This applies only to elective orthopedic surgery without fracture related care and acute care trauma.

How Surgical Orthopedics Stacks up To Regenexx Interventional Orthopedics

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A key benefit of self-funding a health plan is flexibility. Self-funded plans are not constrained in the same way as fully insured plans and employers have the ability to exercise more control over the benefit options and program design they offer their employees. This flexibility has allowed employers to adopt new technologies and innovations more quickly than fully funded plan designs; for example, bariatric surgery was adopted by many employers as a covered health treatment option before fully funded health plans accepted the advancement ¹.

We make the new step in orthopedic care effective by using analytics to best structure an addition to the existing benefits plan and provide ongoing utilization strategies that direct employees through the correct pathway of medical services. This process creates a high value health care option with significant corporate savings.

As mentioned in last month’s newsletter, one of the most effective education tools we provide for employees is the Regenexx benefits card that explains Regenexx as a covered benefit and gives employees the knowledge to make well-informed decisions at the time of an orthopedic event. In addition to the card, Regenexx has created an extensive e-mail education platform to periodically send employees educational information about their covered options in care. Many direct contracting programs do not get adequate employee engagement. Our multi-platform employee education tools are helping employers see utilization results in an unprecedented period of time.

¹ Will Your Health Insurance Pay For Bariatric Surgery?

I CASE STUDY #2: Addition of Monthly Communication

A large national employer with more than 4,300 employees added Regenexx effective 1/1/2019 with an incentive program that pays 100% for Regenexx consultations and a significant portion of procedures. They did not see significant utilization.

We quickly determined that the likely reason for their low utilization was a lack of awareness of the benefit. The benefits card was implemented followed by monthly e-mails to increase inquiry and utilization through member education.

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As a result of this increased education effort, we saw a four-fold increase in employee consultations in less than ¼ the time. Regenexx is only presented when it is most appropriate to intervene on the pathway to orthopedic surgery.

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I INTERVIEW WITH RELPH BENEFIT ADVISORS THE ALERA GROUP PART 1 of 2

Name: Ellen Lindahl, RN, MPA

Title: Clinical Review Director

Industry: Employee Benefits Management / Worker’s Comp
Client Base: Employers with 100 or more benefit eligible employees

What are some of the causes of employee dissatisfaction with current health plans when it comes to orthopedic benefits?

Musculoskeletal disorders--conditions and injuries affecting the bones, joints and muscles--can be painful and debilitating, affecting daily quality of life, activity and productivity. The lack of options to treat these conditions is a major concern for employees. For example, with significant osteoarthritis of the knee and hip, most orthopedic surgeons offer a trial of conservative therapy that may include medications and physical therapy, but when these approaches fail, knee/hip replacement surgery is typically the only other option currently offered to patients. These major surgical approaches typically include an inpatient admission, significant cost, risk, recovery and time away from work and other daily activities. Employees and employers alike are seeking less invasive/less costly approaches that offer equal or better clinical outcomes than invasive surgery.

What is the conversation among your employers when it comes to unnecessary or avoidable orthopedic surgeries that are happening with employees?

Our employers are seeing the rate of knee, hip and shoulder replacements as well as other major orthopedic surgeries rapidly grow, and these procedures are taking a toll in both direct medical costs and also time away from work. Employers are increasingly recognizing that there is little in the evidence-based literature that demonstrates superior clinical outcome for many of these major orthopedic procedures and that there is widespread variation in how likely patients are to undergo them. According to the Dartmouth Atlas, the rate of shoulder replacement is 10 times higher in some regions than others and the rate of knee and hip replacements can be up to four times higher in certain geographic regions. The decision to undergo surgery seems to be influenced more by physician judgement and density of orthopedic surgeons in a given geographic region than by the preferences and values of individual patients or clinical evidence of effectiveness. Employers are very interested in giving their employees high quality care options and access to shared decision-making programs so that well informed choices can be made.

Please explain the considerable time and analysis you went through before introducing the Regenexx Corporate Program to your employers.

Relph Benefits Group does a thorough analysis of all point solution partners to verify they can make a clinical impact and are medically safe. Regenexx has published much more literature on patient outcomes than exists for many other much more invasive (and costly) medical interventions (e.g. carotid endarterectomy, elective gallbladder surgery and hysterectomy to name a few). Regenexx has conducted over 44% of the research in their field (when calculated by the number of patients treated) ², more than all of the other stem cell therapy providers combined, and this gave us the confidence that it was the most tested and researched modality in the orthobiologic space. We looked closely at the randomized control trials, the peer reviewed data and the national Regenexx clinical registry with published outcomes which provided the basis for our confidence and enthusiasm about introducing the Regenexx Corporate Program as a valuable strategy for our clients. We spent considerable analysis in the highest categories of orthopedic surgery such as spine, hip, knee and shoulder to verify for carefully selected patients.

² Orthopedic Bone Marrow Stem Cell Research Summary

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Gilsbar Announces First Ever Partnership for Employees and Gilsbar Employer Groups that Provides Access to Non-surgical Orthopedic Alternatives. Read Here.

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Regenexx Corporate Continues It's Rapid Growth with the Addition of New Self-Funded Employers, Brokers and TPAs as well as Healthcare Interventionalists. Read Here.

I CONTACT US

Find out how you can add Regenexx to your self-funded health plan. Call Regenexx at 877-341-5968.


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Regenexx 6151 Thornton Avenue Des Moines, Iowa 50321 United States (515) 523-7090