AAPPO is pleased to bring you these case studies of employers and health care organizations that have adopted benefit designs and incentives to increase appropriate use of minimally invasive procedures (MIP) as an alternative to open surgery.  Organizations adopted MIP incentives and education as a strategy to reduce hospital length of stay, improve outcomes, and often, improve member satisfaction and speedier return to work.  The case studies were developed by Ethicon Endo-Surgery with input from AAPPO.

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• Colorado Springs School District 11 is an employer with 6000 covered lives.  The employer changed benefit design to include a higher co-payment for open procedures.  The company found significant changes in utilization and cost in the two years of the initiative, along with cost savings.
• Community Medical Center is both an employer and provider of health services.  For employees, CMC eliminated co-pays and deductibles when the employee chooses MIP over an open procedure.  For patients, CMC established a Minimally Invasive Surgery Center of Excellence. The CMC has found decreased length of stays, decreased complications and remissions, and a greater use of outpatient care.
• One Florida School System with 30,000 covered lives implemented an education program on surgical options to increase MIP hysterectomy, breast biopsy and other procedures.  The system educated members and offered benefit incentives for employees to choose MIP.  The school system has seen an increase of MIP over open procedures, with direct medical savings and improved employee productivity.
• Hannaford Brothers is an employer with 10,000 covered lives.  The company offers a higher coverage level of MIP.  It has identified a network of physicians offering MIP, educated employees, and offered nurse counseling for individuals recommended for surgery.  Hannaford has achieved important medical savings and also believes it has saved money on replacement worker costs for employees absent due to surgery. 
• HealthScope Benefits is a third party administrator covering 350,000k lives.  For several employers HealthScope has lowered employee cost sharing for minimally invasive procedures.  Concurrently the TPA adopted a communications campaign to educate members and physicians on the value of MIP. In the future, HealthScope plans to develop a network of MIP qualified surgeons.