Taft-Hartley Dialysis Case Study

In spring 2013, one Taft Hartley Fund signed a contract with SCM to manage its dialysis claims. The fund had previously been applying a 20% PPO discount to its claims and the cost of dialysis was substantial with the plan managing up to 5 patients monthly for dialysis. The SCM legal team reviewed the fund’s Summary Plan Description, and provided recommended wording for inclusion in a plan amendment. The fund approved the amendment and engaged SCM in working with the patients to maintain quality dialysis care at an affordable cost. No member was in any way required to change the source of their dialysis treatments. No member incurred any additional out-of-pocket costs as a result of the involvement of SCM. The results shown below demonstrate the power of the SCM product without costing the patient any additional personal cost or disruption of dialysis service.

Process Month(s)    # of Patients Provider  Billed Charges              SCM Repriced Amount SCM Gross Savings
Aug, 2013 through Jan, 2014 5 $987,388.75 $160,289.39 $827,099.36
February, 2014 3 $172,936.80 $16,752.30 $156,184.50
March, 2014 3 $230,997.79 $21,960.46 $209,037.33
April, 2014 1 $69,699.74 $7,361.79 $62,337.95
May, 2014 3 $147,216.26 $15,285.32 $131,930.94
June, 2014 3 $212,493.63 $22,245.37 $190,248.26
July, 2014 4 $609,100.03 $68,380.53 $540,719.50
August, 2014 5 $616,125.50 $183,246.72 $432,878.78
September, 2014 5 $319,266.14 $66,962.26 $252,303.88
October, 2014 4 $268,407.04 $29,596.83 $238,810.21
November, 2014 5 $343,849.07 $41,985.69 $301,863.38
December, 2014 3 $169,946.85 $16,276.58 $153,670.27
January, 2015 1 $94,770.10 $10,929.76 $83,840.34
February, 2015 1 $52,858.00 $5,736.57 $47,121.43
March, 2015 2 $156,463.50 $15,626.04 $140,837.46
Totals $4,451,519.20 $682,635.61 $3,768,883.59