Many employers don’t understand the total overall economic benefits that can be realized when laparoscopic hysterectomy (LH) is performed instead of total abdominal hysterectomy (TAH). However, GTE Corporation, the telecommunications giant, is not one of them because GTE’s healthcare cost management strategy is focused on the quality of care rather than strictly the cost of care. GTE realizes that the best care is always the least costly, especially when it is delivered by high quality cost effective providers.

Laparoscopic hysterectomy is a perfect example of how the best care can help reduce an employee’s total overall healthcare cost. While the sum of physician and hospital fees for laparoscopic hysterectomy can sometimes be more than that of total abdominal hysterectomy, GTE beneficiaries having an LH are able to return to normal activities much sooner than those who have a TAH. This allows them to return to work earlier thus reducing disability, replacement worker and lost productivity costs for GTE. These cost savings will more than offset the occasionally high additional direct medical costs of laparoscopic hysterectomy in GTE’s view.

So what has stopped LH from becoming the standard of care? One of the main problems is that health plans don’t require it instead of TAH because they are only concerned about the direct medical cost associated with a hysterectomy and are not accountable for the total costs of the procedure to the employer. As long as they continue to be measured only on direct medical costs ( and LH cost more than TAH), it will not be in their financial interest to encourage network providers to perform LH instead of TAH. While the health plans don’t have a financial interest in the cost of disability, productivity or the other non-medical costs associated with hysterectomy, employers like GTE do and they want global costs to be as low as possible. Thus, if LH is going to be a tool that helps better manage the total costs associated with hysterectomy, employers must demand it from their health plans and healthcare providers. We want the best care by the best doctors for our employees and feel cost effective LH performed by “expert” experienced gynecologic surgeons clearly is better for the GTE patient when a hysterectomy is necessary.

The reporting of LH under the frequency of procedures section in the 1998 HEDIS data that will be reported by health plans in 1999 will be one of the first steps to measure the actual utilization of LH in managed care plans. With this information available for the first time, interested employers like GTE will be able to demand improvement from health plans providers in this area. – James Astuto, Regional Healthcare Manager, GTE – See more at:  http://www.obgyn.net/ivf/laparoscopic-hysterectomy-and-health-care-america#sthash.WFRUuFGt.dpuf

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