How to protect your business from the costliest healthcare claims

Neonatal related conditions are consistently among the top ten highest cost claims faced by self-funded employers.  Partner with the specialists who are solving this problem, proactively.

ProgenyHealth: Protecting Employers

What is your risk exposure from premature and medically complex newborn cases?

Such births are already too high, and rising. According to the latest March of Dimes report citing government data, nearly 10% of all births in the US are preterm (less than 37 weeks gestation) – a rate that has increased for three years in a row. The earlier a baby is born, the higher the risk of death or serious disability. 

Premature / low birthweight cases cost employers heavily

This recent March of Dimes’ initiative analyzed the cost impact of premature / low birthweight births versus babies born without such complications. Their report found that employers pay 12 times more in health care costs for premature/low birthweight babies, and that such births add $49,760 to newborn health care costs.

According to the 2018 Sun Life Stop-Loss Research Report, during the 2016 policy year, an employer had a 19.6% chance of having a stop-loss claim related to short gestation or low birthweight. The high complexity of treating these conditions, but the relatively low frequency of their occurrence compared to all claims, makes it difficult for even the largest employers to manage NICU cases very efficiently.

ProgenyHealth helps ensure quality outcomes and reduce claim costs in the care of at-risk infants

Our process and platform are purpose-built and intentionally integrated to help health plans and employers optimize costs and infant quality outcomes in their covered populations.

Our team is made up of neonatologists, NICU nurses, technologists, and business innovators. All of them are committed to ensuring the highest standard of care for each infant we serve.

We are the only national company dedicated to NICU utilization management and case management

That’s how we solve the low-volume, high-complexity problem. Our team has the expertise needed to keep a watchful eye on each baby’s care plan; provide resources, education, and support to the families; and deliver attentive oversight for each case. We collaborate with providers and payers across the country, including every major NICU. And we share that collective experience, along with clinical best practices, with the local NICU doctors and nurses onsite. It’s a peer-to-peer dialogue that helps infants get the best care in the NICU, come home at the right time, with a lower rate of readmissions to the hospital / ER, and access local resources as needed.

Families tell us we are their lifeline in a time of extreme stress and uncertainty. That’s why our member satisfaction surveys are consistently stellar. And that’s why our entire team is motivated to help deliver the best possible outcomes every day.

Finally…real healthcare innovation that benefits both employee and employer

ProgenyHealth’s turn-key services can help improve employee satisfaction, reduce absenteeism, and lower costs. It’s a truly comprehensive solution to a multi-faceted, growing problem. It’s one that has produced quantifiable ROI for major health plans for many years. That’s what innovation is supposed to be about. 

Contact us to discuss how we can implement our solution for your employee base right now, or request our services overview brochure to learn more. 

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Our medical management team worked closely with the experts at ProgenyHealth to deploy this integrated and very effective program. Their singular focus on NICU babies and their families was crucial to the program’s success, and especially vital in building a collaborative relationship with our providers. We’re very pleased with the outcomes of this initiative and the role it plays in our ongoing efforts to help members most at risk of developing serious chronic conditions.
- Dr. Michael Genord
Chief Executive Officer of Health Alliance Plan
The value and benefit of ProgenyHealth to our members’ health and satisfaction alone is worth the cost.
- Health Plan CEO
ProgenyHealth has helped to reduce our ALOS, reduce outlier days, and keep our readmission rates low. Testimonials from our members are full of praise.
- Health Plan CMO