As health care costs continue to burden American businesses, many employers are looking for creative ways to influence and control health benefits costs. One alternative solution to help move the needle is educating employees on topics like “where to seek care.” By educating employees how to navigate the health care ecosystem and how and when to identify the most cost-effective places to receive care, a business can create a ripple effect of savings that benefit both employers and employees. This approach can influence health care costs by reducing the total cost of care. It also can create a sustainable approach to managing employee health benefits and better employee health outcomes.
The ER trap and how non-emergency ER visits affect your business
When employees are unsure about where to seek care, they often default to the convenient and known option: the emergency room (ER). ERs are designed to handle life-threatening emergencies, requiring 24/7 access to specialized staff and advanced technology. However, this convenience comes at a cost. “It is incredibly important for employees to understand early intervention and appropriate ER utilization when deciding to seek care for themselves or their families. When the ER is used for symptoms like urinary tract infections (UTIs) or cold and flu symptoms, it can lead to higher cost for employees, but also expensive expenditures for businesses. Not waiting till symptoms worsen and seeking appropriate care from the right facility can be the difference maker.” shares Gay Poe, Senior Director Health Promotions, at Florida Blue.
Recent studies have shown that 41-66% of ER visits are considered preventable, highlighting the importance of seeking care in a non-urgent setting.1 Furthermore, an ER visit can cost two to three times more than a visit to a primary doctor, making it a costly choice for both employees and employers.2
More than just an ER bill
ER visits can lead to more than just a surprise bill, as they often come with costly facility fees that cover general overhead. These extra expenses are susceptible to inflation and can drive up premium costs, along with the mounting stress from health and financial impacts. Moreover, it’s not just the upfront claim bills that are a concern. ER visits can lead to longer wait and recovery times. This in turn increases your business’s absenteeism and decreases productivity.
In contrast, alternative care support options like in-network primary care doctors or local urgent care centers can be substitutes for expensive ER visits. Unlike traditional emergency rooms, these alternatives, sometimes referred to as ambulatory facilities, are designed to provide convenient, cost-effective, and high-quality medical care. By empowering employees to understand the right care setting, employers may reduce unnecessary ER visits potentially lowering health care costs and improving overall employee health outcomes.
What a profound business impact
By empowering employees with knowledge about selecting the right facility for their health care needs, employers can begin to shift the downstream wind and focus on their comprehensive health.
When employees don’t know where to seek care, they may be more likely to:
- Delay seeking care, leading to more severe health problems and increased costs down the line for the employer
- Seek care from specialists who can have higher costs and lead to reduced care coordination, or poorer health outcomes compared to a primary care physician
- Undergo unnecessary tests and procedures, adding to the overall cost of care and contributing to unnecessary claims
The consequences of employees’ lack of knowledge can be far-reaching, impacting both direct and indirect costs, including:
- High claims and renewal rates, which can lead to increased health care expenses and reduced profitability
- Decreased productivity, as employees may need to take time off to manage their health or deal with the aftermath of delayed or inadequate care
- Absenteeism and presenteeism, where employees may be physically present at work but not fully productive due to health-related issues, impacting performance
By highlighting employees’ care options, resources, and tools available to support informed decision-making, employers can play a vital role in promoting a culture of health care responsibility.
Empower employees to make informed decisions
So, what can you do as an employer to remedy this situation? By collaborating with your health insurance provider or broker, you can explore tools and resources available to help employees make smart decisions. As a business, implement useful strategies like:
- Care setting uses: Educate employees about the different types of care settings, such as primary care, urgent care, and emergency rooms, and when to use each one to avoid unnecessary costs.
- Cost transparency tactics: Direct employees to resources that provide cost information, enabling them to make cost-effective decisions about their care. This can include online tools, mobile apps, or other platforms that offer price transparency.
- Health care navigation: Provide resources and tools to help employees navigate the complex health care system, including customer service phone numbers, online portals, or patient advocacy services.
- Primary and preventive care promotion: Encourage employees to use primary care physicians and urgent care centers for non-emergency care, reducing the likelihood of unnecessary specialist visits and costs.
The importance of employees knowing where to seek care cannot be overstated. That’s why Florida Blue works closely with businesses to provide support for employee decision-making. Don’t let uncertainty about where to seek care hold your business back — take action to empower your employees and help sustain an affordable health care system.
References
1 National Library of Medicine: Medicaid Managed Care in Florida and Racial and Ethnic Disparities in Preventable Emergency Department Visits
2 MedlinePlus: When to use the emergency room
