Surgery by Design™

What is Surgery by Design™?
Surgery by Design enhances employers' benefit plans by incorporating incentives or plan design differentials in a structured decision-support program. Employers can choose levels of engagement commensurate with the company culture to engage employee participation. The various levels include:

  • Encouraging participation through incentive based programs;
  • Driving participation through plan design differentials, such as co-pay or coinsurance differentials or surcharges for non-participants;
  • Mandating participation through a prior authorization process that does not deny care, but requires program participation.

 

When an employee engages in the program, they are guided through a structured process, which ideally includes:

 

What Are the Benefits of Surgery by Design™?
Surgery by Design focuses on plan design enhancements or modifications to maximize employee participation in a structured decision support process to ensure:

  • Patients find the right doctors to treat their problem,
  • Patients make optimal treatment decisions,
  • Patients are well prepared for the hospital or surgery center and for recovery,
  • Patients learn how to stay healthy,
  • Surgical cost components are tracked, to promote transparency.
  • Functional and clinical outcomes are documented, promoting transparency.