A client with a large trust scheme switched to a Healix Healthcare Trust from a PMI provider in order to help improve cost control and benefit from our nurse led case management service. To make it possible for the company to achieve further savings, we proposed the introduction of incentivising employees to opt for treatment in an appropriate NHS Centres of Excellence where it was to the clinical benefit of employees.
With our highly qualified and 100% nurse dedicated case management team, we are able to proactively manage cases and help navigate patients effectively between NHS and private treatment where appropriate.
The introduction of a realistic high value NHS cash benefit, reflecting the actual savings made on certain high cost treatments, means that we are able to deliver significant savings to the employer where NHS treatment is in the best interest of the patient and the patient is happy to be treated on the NHS. However, it is crucial to note that the choice of private or NHS treatment remains with the employee.
One case that clearly demonstrates this approach related to a 40 year old male who contacted the Healix Healthcare Hotline after being referred by his GP for a CT scan following preliminary investigations which revealed shadowing to his lungs and abnormal blood results. He was understandably worried about delays for a CT scan with the NHS.
The Healix nurses quickly reassured him by making arrangements with his consultant and the hospital for a private scan. However, the NHS came through with a very quick appointment and the patient decided to have the scan on the NHS after all.
He was diagnosed with Myeloma, a cancer of the white blood cells, and needed radiotherapy and chemotherapy treatment over the following seven months. The Healix nurses advised him that he could choose for his treatment to be done privately or at a local NHS hospital with the same consultant. As the NHS hospital had better medical facilities and there was no waiting time, he was happy to be treated on the NHS. His Healix case manager assured him that if he experienced any problems with the NHS, she would manage the transition to switch him back to private treatment.
We were able to support him throughout all his treatment, giving him the reassurance that he could speak to his nurse case manager if he ever felt he needed help or advice. He also received a £24,600 cash benefit - as a result of going through the NHS rather than privately - which was very helpful at a difficult time.
His employer also benefited significantly. The final cost to them was just £24,600 instead of the £139,000 it would have cost if treatment had been done privately.