Critical illness management: Preparing for - not reacting to - critical illness.

Preferred Care protects you and your loved ones in the unfortunate but common occurence of a life-threatening illness. The statistics are sobering: cardiovascular disease and cancer are leading causes of death globally, exceeding by far the likelihood of fatal accidents.

Deaths per 100,000¹

You may have concerns over important issues in the case that critical illness should strike:

• Affording catastrophic medical expenses
• Experiencing a loss of income from becoming disabled
• Needing to provide financial and medical support to a family member experiencing critical illness
• Being unable to access the best doctors
• Long waiting lines
• The stress of being reimbursed for catastrophic medical expenses

While local care may be excellent for less serious conditions, treating a critical illness successfully requires the global best – in medical practice and quality control – and a patient-centered approach designed to tackle serious issues like misdiagnosis, medical mistakes, delays and sub-optimal treatments, while financing it all.

The all too common mistakes that lead to needless death or disability.

PGH’s Preferred Care program ensures that effective teaming between you, the hospital and your own PGH Care Management team produces the best outcome and maintains the highest quality throughout the process.

Preferred Care is about getting the best treatment and outcome. Our world-class support system provides preeminent medical expertise for local treatment and in those cases where local care cannot provide the expertise or critical mass necessary, we orchestrate and finance the global best medical practice to maximize your likelihood of survival. The U.S. is where we have the evidence to support our best practice approach. Click here to find out why.

Your health - not your wallet - is our focus.

We work with and for you to ensure the consistent application of best practice from the moment you're diagnosed until your complete recovery.

• Unlike a lump sum payment, Preferred Care’s global network of excellence is a world-class support system designed only for you to get better and return to a healthy and normal life.
• Cost is never a factor in treatment decisions, only best care. Your policy gives you USD 2 million for medical treatment and USD 20,000 for travel and accommodation for you and one companion.
• Treatment is never limited to what is available locally.
• We place the patient at the center of health care, empowering them relative to providers, insurers and the national health system.

We are committed to providing a program whose value far exceeds its cost. These seven factors highlight the success of the program:

1. Diagnosis Verification and Treatment Planning (DVTP) - to make sure you have the correct diagnosis and treatment plan.
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   The first step in the Preferred Care process, the DVTP evaluates and confirms that the primary diagnosis undertaken by your physician is accurate and complete. It also provides a personalized treatment plan tailored to your specific condition by a top U.S. specialist, while allowing you to make informed decisions. This is to prevent misdiagnosis and to ensure that you have the treatment plan that reflects your best interest and the technologies and state-of-the-art procedures proven to make a full recovery.

   A DVTP can have great impact on treatment. Results published in the British Medical Journal state that Harvard doctors changed the treatment plans for 90% of the patients and revised the diagnosis in 5% of the cases that were involved in the DVTP program. The care change most often involved a new chemotherapy regimen, i.e. non-trivial care decisions.1

   Additionally, according to the World Health Organization, while diagnostic errors are encountered in every medical specialty, they can be studied most easily in fields such as radiology, pathology and dermatology, because the actual diagnostic material can be re-reviewed by other observers, uncovering errors and allowing discrepancy rates to be measured. A classic, often tragic example is misdiagnosis of cancer, either false-positive or false-negative, both being associated with potentially devastating medical, psychological and legal consequences. This allows for verification at a Center of Excellence, lessening the chances of reading errors.2

   The DVTP also gives you access to Harvard-affiliated medical expertise by having your condition and medical information reviewed remotely without ever needing to leave your home country. To learn more about the DVTP, click here.

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2. Treatment at High Volume Hospitals by High Volume Surgeons - proven to result in high chance of survival.
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   Patients treated at high-volume hospitals by experienced specialists who treat high volumes of cases are proven to have a lower chance of mortality and complications.
   

   A study released by HealthGrades, the leading independent healthcare ratings organization, concluded that patients treated at top-rated hospitals across the most common diagnoses and procedures are 27% less likely to die, on average, than those admitted to all other hospitals. The report also said that patients who undergo surgery at these high performing hospitals also have an average 8% lower risk of complications during their stay.3

   Preferred Care memebers are treated only at the top 1% of hospitals in the world's best funded medical system with the highest survival rates, the U.S., to ensure optimal quality of treatment and care. We rely on the most comprehensive independent rating system - The Annual Hospital Survey conducted by U.S. News and World - to select the top 1% of hospitals: hospitals that consistently deliver the best medical outcomes under the most demanding and complex situations and that are ranked under a wide range of factors, such as specialties from cancer to heart disease, hard data like death rates and number of nurses, and reputation within the medical community.

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3. Preventable Medical Error Reduction - lowering the chances for medical mistakes.
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   Achieving best outcome from critical illness includes eliminating the chances for medical error to occur - errors that are causing a mortality level only surpassed by cardiovascular disease and cancer. PGH's excellent case management and integration of a Personal Care Manager greatly reduces these chances.

   A study released in Health Affairs in 2003 described high rates of medical error, lack of care coordination and poor communication between patients and their doctors, resulting in 20-25% of all patients experiencing preventable medical errors. PGH has invested in verifying that the combination of best practice and quality control prevents both medical errors and complications that are costly for the patient by resulting in inferior outcomes and for the insurer in terms of higher costs. The results of the study confirm the PGH rationale of providing you with a dedicated Personal Care Manager (PCM) to encourage better process control and integrated care.4 To learn more about Care Management Services, click here.

   PGH has experienced virtually zero preventable medical errors, and due to these resulting fewer complications, PGH has achieved better outcomes for its members and an average cost level per critical illness case that is almost 60% lower than the insurance industry’s loss ratio. As such, the cost of PGH membership has remained consistently low, while that of other providers and insurance has steadily increased.

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4. Patient Involvement - empowering you to make informed treatment decisions.
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   Beyond preventable medical errors, most people fear the loss of influence and the anonymous, sometimes helpless sensations that accompany becoming a patient. Studies are increasingly showing the value of patients being involved in their own care, and PGH sees patient involvement as an essential part of the treatment process that encourages a better outcome.

   The Personal Care Manager is there to ensure you are heard, and that individual needs and preferences are met, extending from minimizing waiting times to ensuring transparency and your participation in decision making. Moreover, PGH ensures that your're involved in all decision making and that you have the necessary information to make meaningful and educated decisions.

   According to the World Alliance for Patient Safety, the challenges posed by ‘patient safety’ have been addressed mainly from a system perspective. That is, clinicians and policy-makers increasingly recognize that many errors and adverse events are linked to the design of health care systems and their features, such as poor communication, lack of human factors engineering and a poor safety culture. Further, the involvement of patients and family members as fully contributing members of the health care team is increasingly recognized as an additional, necessary systemic safeguard as the complexity of health care continues to increase. Bringing together groups of patients and their families in advisory councils in partnership with healthcare administrators and providers is increasingly showing its value and importance for changing the way health care systems operate.5

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5. Best Protocol Control - using standardized processes for quality control and consistency.
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   Several studies suggest that a consistent application of standardized protocols aimed at achieving best outcome will reduce mortality rates. PGH recognizes the importance of having systemic processes in place to enhance quality-control.

   This concept is used in two ways: PGH uses an internal proven protocol to manage the treatment process of every patient, while PGH’s patients are treated at those hospitals which have the most effective systems in place.

   PGH reinforces standards and quality by following simple steps that can make a big difference. These include reducing reliance on memory and vigilance, simplifying where possible, using checklists and ensuring that intended medications are clear. The existence of confusing drug names is one of the most common causes of medication error and is of concern worldwide. With tens of thousands of drugs currently on the market, the potential for error due to confusing drug names and proprietary names. For example, names like Flomax and Volmax sound extremely similar, but one is used to treat the symptoms of an enlarged prostate, and the other is used to relieve bronchospasm.

   Another problem with drug names exists across international borders. Drug names can vary from country to country, and the situation can be disturbing. For instance, Norpramin, which is an antidepressant in the U.S., is the name of an ulcer drug in Spain. Flomax for prostate disease has the same name as a pain medication in Italy, and Vivelle, which in the U.S. is a hormone treatment for menopause and osteoporosis, is a birth-control pill in Austria. It is part of our commitment to excellence that PGH ensures the patient receives the proper medication not only in the U.S. during treatment, but also in their home country after their return home for recovery.

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6. Proactive Recovery Plans - continuing best practice through the recovery stage.
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   Systematic post surgery recovery plans are critical to reduction in mortality and improved longevity. A patient can undergo a series of treatments, but cannot be returned to complete health without proper recovery.Our focus on the patient lasts after they return home post-treatment in the U.S., to ensure that they receive the proper care and attention during the rehabilitation phase of their treatment.

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7. Best Quality to Cost Ratio - keeping costs down without compromising the quality of the treatment plan.
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   PGH’s unique commitment to and ability to achieve lower costs for insurance and treatment results in reduced premiums for members. Pro-actively managing case results to reduce preventable medical errors leads to insurer group and provider discounts ironically due to the overall reduced cost of completing treatment correctly the first time, instead of constraining costs for procedures.

   Industries with complex, multi-stage production systems and processes have long understood that quality controls and continual improvements increase customer satisfaction, deliver better results and lower costs. This is why PGH focuses on quality-controlling the treatment process; “doing it right the first time” is outcome effective and cost efficient more so in healthcare than in any other industry.

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