title: Procedure-specific costs and savings in a mandatory program for second opinion on surgery.
abstract: Initial examination of the surgery experience of participants in a large employer-sponsored second opinion program revealed minimal savings in medical resource costs. But closer examination of relative savings for specific procedure categories showed that the greatest savings are for high-cost procedures: hysterectomy, prostatectomy, back surgery, and hip replacement. Furthermore, a nonconfirming second opinion does not dissuade patients from some procedures. Decisions about which procedures to include in a mandatory program should consider volume, costs, and effects of nonconfirmation, as well as the advantages of a mandatory second opinion for skeptical patients, or for patients for whom a controversial procedure has been recommended.
authors.affiliation: New York Business Group on Health, New York City.
authors.forename: J K
authors.initials: JK
authors.lastname: Barr
authors.forename: M
authors.initials: M
authors.lastname: Schachter
authors.forename: S N
authors.initials: SN
authors.lastname: Rosenberg
authors.forename: P
authors.initials: P
authors.lastname: Factor-Litvak
authors.forename: M R
authors.initials: MR
authors.lastname: McGarvey
authors.forename: L
authors.initials: L
authors.lastname: Leto
mesh_terms: D054598:Blue Cross Blue Shield Insurance Plans; D003363:Cost Control; D003362:Cost-Benefit Analysis; D003657:Decision Making; D006801:Humans; D009519:New York City; D009786:Occupational Health Services / Q000458:organization & administration*; D015397:Program Evaluation; D012017:Referral and Consultation / Q000331:legislation & jurisprudence*; D013514:Surgical Procedures, Operative / Q000706:statistics & numerical data*