We all know health care costs continue to increase year overyear, often by more than 5 percent. But what if I told you thatright now, approximately 6 percent of your clients’ medical spendwas on just five common surgeries? What if I went on to tell youthat as often as half of the time, these surgeries may not beneeded, according to medical evidence, and/or are notwanted by employees, who have other treatment options.This would represent an incredible opportunity to bend the costtrend and improve health outcomes.

The big brains behind the Dartmouth Atlas were among the firstto clue us in that there is widespread variation in the number andtypes of surgeries performed across the country. For example, onemajor metropolitan city may have patients three times more likelyto have a knee replacement, compared to another. The explanationfor the difference is not the patient population — it is thesurgeons. In some regions, it is more fashionable or culturallyacceptable to reach for the scalpel as the first option, even whenmedical evidence says there are other treatment options. And, ofcourse, in many of these cases, the patient would want a lessinvasive treatment option, too.

This led the Dartmouth experts to conclude, “Changing the practice of medicineso that treatment choices reflect patients’ preferences has thepotential to radically change the consumption and quality of healthcare.”

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